Optimizing Motor Learning in Older Adults.

OBJECTIVES: According to the Optimizing Performance Through Intrinsic Motivation and Attention for Learning (OPTIMAL) theory of Wulf and Lewthwaite, enhanced expectancies (EE), autonomy support (AS), and an external focus (EF) of attention facilitate motor performance and learning. The present study examined whether consecutive implementation of EE, AS, and EF during practice would enhance the learning of a square-stepping task in older adults. METHODS: Participants were randomly assigned to optimized and control groups. After the pretest, 1 of the 3 factors was implemented during each of the three 12-trial practice blocks, in a counterbalanced order, in the optimized group: positive feedback (EE), choice of mat color (AS), and instructions to focus on the squares (EF). Control group participants practiced without any of these factors. RESULTS: Results indicated that the optimized group had faster movement times than the control group during the practice phase and on 24-hr retention and transfer tests. DISCUSSION: The key variables in the OPTIMAL theory can be applied sequentially in order to facilitate motor performance and learning in older adults.

Golf skill learning: An external focus of attention enhances performance and motivation.

An external focus of attention has been shown to enhance the performance and learning of motor skills, relative to an internal focus (see Chua, Jimenez-Diaz, Lewthwaite, Kim, & Wulf, 2021). In the present study, we examined possible motivational consequences of learners' experience of greater movement success with an external focus. Participants were asked to learn a golf pitch shot. In addition to measuring learning, we assessed self-efficacy, as well as positive and negative affect in groups that received external versus internal focus instructions. Furthermore, we examined the feasibility of providing several focus instructions in the same practice session as the learning of complex skills typically requires more than one instructional cue. The results showed that skill learning was enhanced by instructions that promoted external foci, as measured by golf shot accuracy on delayed retention and transfer tests. The external focus group also showed higher positive affect and reduced negative affect at the end of practice, and higher self-efficacy before retention testing, compared with the internal focus group. These findings provide support for several assumptions of the OPTIMAL theory (Wulf & Lewthwaite, 2016). From a practical perspective, they highlight the attentional and motivational benefits of an external focus.

A distal external focus of attention facilitates compensatory coordination of body parts.

Many studies have shown that focusing on an intended movement effect that is farther away from the body (distal external focus) results in performance benefits relative to focusing on an effect that is closer to the body (proximal external focus) or focusing on the body itself (internal focus) (see, Chua, Jimenez-Diaz, Lewthwaite, Kim & Wulf, 2021). Furthermore, the advantages of a distal external focus seem to be particularly pronounced in skilled performers (Singh & Wulf, 2020). The present study examined whether such benefits of more distal attentional focus may be associated with enhanced functional variability. Volleyball players (n = 20) performed 60 overhand volleyball serves to a target. Using a within-participants design, the effects of a distal external focus (bullseye), proximal external focus (ball) and an internal focus (hand) were compared. The distal focus condition resulted in significantly higher accuracy scores than did the proximal and internal focus conditions. In addition, uncontrolled manifold analysis showed that functional variability (as measured by the index of synergy) was greatest in the distal focus condition. These findings suggest that a distal external focus on the task goal may enhance movement outcomes by optimising compensatory coordination of body parts.

Mind over body: Creating an external focus for sport skills.

In a recent study examining the efficacy of different external foci (Singh and Wulf [2020]. The distance effect and level of expertise: Is the optimal external focus different for low-skilled and high-skilled performers? Human Movement Science, 73. https://doi.org/10.1016/j.humov.2020.102663), an external focus instruction referred to parts of the body (arms). Specifically, the image of a "platform" was used to describe the area between the wrists and elbows when passing a volleyball. The present study followed up on that study by addressing the question whether a focus on an image that represents a body part (platform) would be more effective than a focus on the body parts (arms) themselves (i.e. internal focus). In a within-participant design, novice volleyball players continuously passed a volleyball to a target on the wall. Participants completed eight 45-s trials under each of the external ("focus on your platform") and internal focus ("focus on your arms") conditions, performed in a counterbalanced order. The results showed that the total score (i.e. sum of scores over 45 s) was significantly higher when participants focused on the platform rather than their arms. Thus, invoking an image of an external object that "replaces" a body part can serve to promote an external focus that results in immediate performance advantages compared with an internal focus on the same body part. The findings suggest that instructors within a range of applied settings can creatively use such images to facilitate the performance of motor skills.Highlights The image of an object ("platform") is used to promote an external focus in volleyball.Novice volleyball players pass a ball to a target with a focus on the platform versus arms.Passing accuracy is superior with an external (platform) relative to an internal focus (arms).Using the image of an object to "replace" a body part can promote an external focus of attention.

Superiority of external attentional focus for motor performance and learning: Systematic reviews and meta-analyses.

Considerable literature on the role of attentional focus in motor performance and learning has accumulated for over two decades. We report the results of comprehensive meta-analyses that address the impact of an external focus (EF, on intended movement effects) versus internal focus (IF, on movements of body parts) of attention on the performance and learning of motor skills. Values of effect sizes (ES) from 73 studies with 1,824 participants and 40 studies with 1,274 participants were used for examining the effects of EF versus IF on behavioral outcomes of motor performance and learning (separately for retention and transfer phases) respectively. The EF condition was more effective than the IF condition for performance, Hedges' g value = 0.264 (95% CI [0.217, 0.310]), retention learning, Hedges' g value = 0.583 (95% CI [0.425, 0.741]), and transfer learning, Hedges' g value = 0.584 (95% CI [0.325, 0.842]). Multivariable metaregression analyses on behavioral measures further indicated that neither age group, health status, or skill level, nor their two-way interactions, moderated the ES differences between EF and IF in performance, retention, and transfer models (all p > .100). A secondary analysis on 12 studies with 216 participants that examined the effects of EF versus IF on electromyographic outcomes of motor performance also indicated that EF was associated with more efficient neuromuscular processing, Hedges' g value = 0.833 (95% CI [0.453, 1.213]). From nine studies with 272 participants, performance measured by behavioral outcomes was found to be more effective when a more distal, rather than proximal, EF was used, Hedges' g value = 0.224 (95% CI [0.019, 0.429]). Overall, the meta-analytic results are consistent with prior narrative reviews and indicate that an external focus is superior to an internal focus whether considering tests of motor performance or learning, and regardless of age, health condition, and level of skill expertise. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

More bang for the buck: autonomy support increases muscular efficiency.

The purpose of this study was to examine whether conditions that provide performers with a sense of autonomy, by giving them choices, would increase movement efficiency. We evaluated neuromuscular activation as a function of choice, using surface electromyography (EMG), during isometric force production. Participants (N = 16) were asked to perform plantar flexions at each of three target torques (80%, 50%, 20% of maximum voluntary contractions) under both choice and control conditions. In the choice condition, they were able to choose the order of target torques, whereas the order was pre-determined in the control condition. Results demonstrated that while similar torques were produced under both conditions, EMG activity was lower in the choice relative to the control condition. Thus, providing performers with a choice led to reduced neuromuscular activity, or an increase in movement efficiency. This finding is in line with the notion that autonomy support readies the motor system for task execution by contributing to the coupling of goals and actions (Wulf and Lewthwaite, Psychon Bull Rev 23:1382-1414, 2016).

Forward thinking: When a distal external focus makes you faster.

Studies have demonstrated a benefit to performance and learning of a distal relative to a proximal external focus of attention. That is, focusing on a movement effect that occurs at a greater distance from the body has been found to be more effective than concentrating on a movement effect closer to the body. The present study examined the distance effect in skilled kayakers performing an open, continuous skill. Participants (n = 27) performed a wild water racing sprint of 100 m on Class 2 water. Using a within-participants design, a distal external focus ("Focus on the finish") was compared to a proximal external focus ("Focus on the paddle") as well as to a control condition. The distal focus condition (30.63 s, SD = 3.21) resulted in significantly shorter sprint times than did the proximal (32.07 s, SD = 3.27) and the control (31.96 s, SD = 3.58) conditions (ps < 0.001). The effect size was large (ηp2 = 0.53). There was no significant difference between the proximal and control condition (p = 1.00). The findings demonstrate the importance of adopting a distal, rather than proximal, external focus for skilled athletes performing open, continuous skills under time pressure.

The distance effect and level of expertise: Is the optimal external focus different for low-skilled and high-skilled performers?

Focusing attention on a movement effect that is farther away from the body (distal external focus) has been shown to result in more effective motor performance or learning than focusing on an effect that is in greater proximity to the body (proximal focus). The present study examined whether the distance of the external focus impacts the performance of relatively inexperienced and experienced performers differently. Low-skilled and high-skilled volleyball players passed a volleyball continuously to a target. In the proximal focus condition they were asked to concentrate on the "platform," whereas in the distal focus condition they were instructed to concentrate on the target. The high-skilled group's accuracy scores were higher in the distal relative to proximal focus condition. However, low-skilled players' accuracy scores was greater in the proximal relative to distal focus condition. We argue that the optimal distance of the external focus depends on the level of expertise when the skill requires a specific movement technique. An external focus on that technique seems to be more advantageous for low-skilled performers. In contrast, when the movement pattern has become more automatic (high-skilled performers), a focus on the overall movement effect is more beneficial.

Maximal force production requires OPTIMAL conditions.

The OPTIMAL theory of motor learning identifies several motivational and attentional factors that draw out latent motor performance capabilities. One implication of the OPTIMAL theory of motor learning (Wulf & Lewthwaite, 2016) is that standardized motor performance assessments likely do not reflect maximal capabilities unless they are "optimized" with appropriate testing conditions. The present study examined the effects of three key motivational (enhanced expectancies, EE, and autonomy support, AS) and attentional (external focus, EF) variables in the OPTIMAL theory on maximum force production. In Experiment 1, a handgrip strength task was used. EE, AS, and EF were implemented, in a counterbalanced order, on consecutive trial blocks in an optimized group. A control group performed all blocks under neutral conditions. While there were no group differences on Block 1 (baseline), the optimized group outperformed the control group on all other blocks. In Experiment 2, participants performed two one-repetition maximum (1-RM) squat lift tests, separated by one week. Two groups, an optimized group and control group, had similar 1-RM values on the first test performed under neutral conditions. However, on the second test, a group performing under optimized conditions (EE, AS, EF) showed an increase in 1-RM, while there was no change from the first to the second test for a control group. We argue that standard test conditions may not produce true maximal performance. The findings corroborate the importance of key factors in the OPTIMAL theory and should be applied to ensure accurate strength performance assessment.

Choose your words wisely: Optimizing impacts on standardized performance testing.

BACKGROUND: The OPTIMAL theory of motor learning identifies motivational (enhanced expectancies, EE, and autonomy support, AS) and attentional (an external attentional focus, EF) factors that affect motor performance and learning [1]. One implication of this theory is that standardized clinical and laboratory assessments of physical capacity and motor performance that do not incorporate optimizing conditions may underestimate true maximal capabilities. The influence of "optimized" conditions on a clinical-applied test of balance control was examined with healthy participants. Given the motor performance benefits of optimized conditions predicted by the OPTIMAL theory, it was hypothesized that providing participants with information that induced EE, provided them with AS, and promoted their use of EF would reduce balance errors and postural sway. METHODS: We used as an exemplar assessment, the Balance Error Scoring System (BESS), and center-of-pressure (COP) velocity measurements of postural sway. Participants performed under two different conditions, separated by two days: an optimized (EE, AS, and EF) condition and a control ("neutral") condition, with sample-wide order counterbalancing. In each condition, participants performed three stances (double-leg, single-leg, and tandem) on two support surfaces (firm and foam). Stance order was participant-determined in the optimized condition and, for the control condition, yoked to a participant in the optimized condition. RESULTS: Participants committed fewer balance errors in the optimized condition than in the control condition (p < .001) and their resultant COP velocity in the optimized condition was lower than that in the control condition (p = .004). BESS scores were correlated with resultant COP velocity (r = .593, p < .001). SIGNIFICANCE: Our results demonstrated the impact of implementing optimized, as opposed to "neutral" control, conditions for better insight into balance capabilities in normal and challenging situations. Practitioners' roles in mediating test situations and using subtle wording to promote optimized performance may have consequential impacts on motor assessment outcomes.

Practice variability promotes an external focus of attention and enhances motor skill learning.

Variability in practice has been shown to enhance motor skill learning. Benefits of practice variability have been attributed to motor schema formation (variable versus constant practice), or more effortful information processing (random versus blocked practice). We hypothesized that, among other mechanisms, greater practice variability might promote an external focus of attention on the intended movement effect, while less variability would be more conducive to a less effective internal focus on body movements. In Experiment 1, the learning of a throwing task was enhanced by variable versus constant practice, and variable group participants reported focusing more on the distance to the target (external focus), while constant group participants focused more on their posture (internal focus). In Experiment 2, golf putting was learned more effectively with a random compared with a blocked practice schedule. Furthermore, random group learners reported using a more effective distal external focus (i.e., distance to the target) to a greater extent, whereas blocked group participants used a less effective proximal focus (i.e., putter) more often. While attentional focus was assessed through questionnaires in the first two experiments, learners in Experiment 3 were asked to report their current attentional focus at any time during practice. Again, the learning of a throwing task was more effective after random relative to blocked practice. Also, random practice learners reported using more external focus cues, while in blocked practice participants used more internal focus cues. The findings suggest that the attentional foci induced by different practice schedules might be at least partially responsible for the learning differences.

Autonomy enhances running efficiency.

Performer autonomy has been shown to contribute to effective motor performance and learning. Autonomy support is therefore a key factor in the OPTIMAL theory of motor learning (Wulf, G., & Lewthwaite, 2016). The purpose of the present study was to examine whether supporting individuals' need for autonomy by giving them choices would increase movement efficiency. Such a finding would be consistent with the OPTIMAL theory prediction that autonomy facilitates the coupling of goals and actions. Participants (N = 32) were asked to run at a submaximal intensity (65% of VO2 max) for 20 minutes. Before the run, participants in a choice group were able to choose 5 of 10 photos as well as the order in which they would be shown to them on a computer screen during the run. Control group participants were shown the same photos, in the same order, chosen by their counterparts in the choice group. Throughout the run, oxygen consumption and heart rate were significantly lower in the choice group than the control group. Thus, providing autonomy support resulted in enhanced running efficiency. The present findings are in line with the notion that autonomy facilitates goal-action coupling.

Onward and upward: Optimizing motor performance.

In the OPTIMAL theory of motor learning (Wulf & Lewthwaite, 2016), three factors are postulated to facilitate motor performance and learning: Enhanced expectancies (EE) for performance, autonomy support (AS), and an external focus (EF) of attention. We examined whether EE, AS, and EF would have immediate performance benefits and whether implementing these factors consecutively would lead to incremental performance increases. Participants were assigned to the optimized or control groups and performed a maximal jump. After the first trial block (baseline), optimized group participants were provided different conditions on each of the following 3 blocks: (a) Positive social-comparative feedback (EE); (b) choice of figure on the ground from which to jump (AS); and (c) instructions to focus on a marker on their waist (EF). The order of conditions was counterbalanced. Control group participants performed all 4 blocks under the same (control) condition. The optimized group outperformed the control group on Blocks 2-4. Moreover, their jump height increased with each addition of another variable, whereas it did not change across blocks in the control group. Thus, EE, AS, and EF had additive or incremental benefits for performance. The findings corroborate the importance of key variables in the OPTIMAL theory for motor performance.

Maximal aerobic capacity can be increased by enhancing performers' expectancies.

BACKGROUND: Maximum aerobic capacity (VO2max) is widely accepted as the best measure of cardiovascular fitness and aerobic power. The present study investigated whether enhancing participants' performance expectancies through positive social-comparative feedback would increase VO2max. METHODS: Participants were experienced runners who regularly ran for exercise or competitively. All participants completed two VO2max tests within a 2-week period at similar times of the day. Before the second test, enhanced expectancy group participants were informed that their aerobic capacity on the first test was above the group average, whereas control group participants were told the second test was for validation purposes. Measurements taken were relative to VO2max, as well as pulmonary ventilation, respiratory exchange ratio, heart rate, and ratings of perceived exertion. RESULTS: The enhanced expectancy group demonstrated a significant increase (+3.28%) in VO2max from test 1 (61.1±2.8 mL·kg-1·min-1) to test 2 (63.7±2.9 mL·kg-1·min-1, P=0.007), whereas the control group's VO2max decreased significantly (-4.11%, test 1 =59.4±2.9 mL·kg-1·min-1, test 2 =57.8±2.3 mL·kg-1·min-1, P=0.027). No group differences were found with respect to other performance measures (pulmonary ventilation P=0.22, heart rate P=0.97, respiratory exchange ratio P=0.11, rate of perceived exertion P=0.13). CONCLUSIONS: The results show that maximum aerobic capacity is, in part, a function of the performer's self-efficacy expectations. These findings add to the increasing evidence demonstrating social-cognitive-affective influences on (maximum) motor performance.

Triple play: Additive contributions of enhanced expectancies, autonomy support, and external attentional focus to motor learning.

In the OPTIMAL theory of motor learning [Wulf, G., & Lewthwaite, R. (2016). Optimizing performance through intrinsic motivation and attention for learning: The OPTIMAL theory of motor learning. Psychonomic Bulletin & Review, 23, 1382-1414], 3 factors are postulated to facilitate learning: enhanced expectancies (EE) for performance, autonomy support (AS), and an external focus (EF) of attention. In 3 recent studies, combinations of 2 of these variables resulted in superior learning relative to the presence of only 1 variable, or none. We examined whether the combination of all 3 factors would enhance learning relative to combinations of 2 factors. Our design included EE-AS, EE-EF, AS-EF, and AS-EE-EF groups. Participants threw balls at a target with their non-dominant arm. In the EE conditions, they received positive social-comparative feedback. In the AS conditions, they were allowed to throw with their dominant arm on trial blocks chosen by them. In the EF conditions, participants were asked to focus on the target. On a delayed retention test, the AS-EE-EF group outperformed all other groups. The findings provide evidence that enhanced expectancies, autonomy support, and an external focus can contribute in an additive fashion to optimize motor learning.

Lassoing Skill Through Learner Choice.

The authors examined several issues related to the motor learning benefits resulting from giving learners choices. In 2 experiments, participants practiced a novel task, throwing a lasso. In Experiment 1, giving learners a choice ostensibly irrelevant to performance (color of mat under target) resulted in enhanced learning relative to a control group. The choice group also reported more positive affect. Experiment 2 compared the effectiveness of task-irrelevant (mat color) versus task-relevant (video demonstrations of the skill) choices. In both choice groups, each participant was yoked to a participant in the other group, and each received the same mat color or saw the video demonstration, respectively, as chosen by their counterpart in the other group. In the control group, participants were yoked to their respective counterparts in each of the choice groups. On a retention test, the 2 choice groups did not differ from each other, but both outperformed the control group. The affective and learning effects seen when learners are given choices, and the fact that task-relevant and task-irrelevant choices resulted in similar learning benefits, are consistent with a content-neutral mechanism for the effects of choice on learning, as described in the OPTIMAL theory of motor learning (Wulf & Lewthwaite, 2016 ).

Autonomy facilitates repeated maximum force productions.

Performer autonomy (or self-control) has consistently been shown to enhance motor learning, and it can also provide immediate benefits for motor performance. Autonomy is also a key variable in the OPTIMAL theory of motor learning (Wulf & Lewthwaite, 2016). It is assumed to contribute to enhanced expectancies and goal-action coupling, affecting performance effectiveness and efficiency. The purpose of the present study was to examine whether providing autonomy support by giving performers choices would enhance their ability to maintain maximum force levels. Participants were asked to repeatedly produce maximum forces using a hand dynamometer. After 2 initial trials with the dominant and non-dominant hand, stratified randomization was used to assign participants with the same average maximum force to one of two groups, choice or yoked control groups. Choice group participants were able to choose the order of hands (dominant, non-dominant) on the remaining trials (3 per hand). For control group participants, hand order was determined by choice-group counterparts. Maximum forces decreased significantly across trials in the control group, whereas choice group participants were able to maintain the maximum forces produced on the first trial. We interpret these findings as evidence that performer autonomy promotes movement efficiency. The results are in line with the view that autonomy facilitates the coupling of goals and actions (Wulf & Lewthwaite, 2016).

Optimizing motivation and attention for motor performance and learning.

We review three lines of recent research at an intersection of motor learning and sport psychology as they relate to motor skill acquisition: enhanced expectancies, autonomy support, and external attentional focus. Findings within these lines of research have been integrated into a new theory, the OPTIMAL (Optimizing Performance through Intrinsic Motivation and Attention for Learning) theory (i.e., OPTIMAL theory, Wulf and Lewthwaite, 2016), and have been applied in motor skill acquisition and performance. Implications range from more effective skill development in children and novice performers to athletes and performers in many fields, including clinical rehabilitation.

Enhancing performance expectancies through visual illusions facilitates motor learning in children.

In a recent study by Chauvel, Wulf, and Maquestiaux (2015), golf putting performance was found to be affected by the Ebbinghaus illusion. Specifically, adult participants demonstrated more effective learning when they practiced with a hole that was surrounded by small circles, making it look larger, than when the hole was surrounded by large circles, making it look smaller. The present study examined whether this learning advantage would generalize to children who are assumed to be less sensitive to the visual illusion. Two groups of 10-year olds practiced putting golf balls from a distance of 2m, with perceived larger or smaller holes resulting from the visual illusion. Self-efficacy was increased in the group with the perceived larger hole. The latter group also demonstrated more accurate putting performance during practice. Importantly, learning (i.e., delayed retention performance without the illusion) was enhanced in the group that practiced with the perceived larger hole. The findings replicate previous results with adult learners and are in line with the notion that enhanced performance expectancies are key to optimal motor learning (Wulf & Lewthwaite, 2016).

Choices enhance punching performance of competitive kickboxers.

While self-controlled practice has been shown to enhance motor learning with various populations and novel tasks, it remains unclear if such effects would be found with athletes completing familiar tasks. Study 1 used a single case-study design with a world-champion kickboxer. We investigated whether giving the athlete a choice over the order of punches would affect punching velocity and impact force. Separated by 1 min of rest, the athlete completed 2 rounds of 12 single, maximal effort punches (lead straight, rear straight, lead hook and rear hook) delivered to a punching integrator in a counterbalanced order over six testing days. In one round the punches were delivered in a predetermined order while in the second round the order was self-selected by the athlete. In the choice condition, the world champion punched with greater velocities (6-11 %) and impact forces (5-10 %). In Study 2, the same testing procedures were repeated with 13 amateur male kickboxers over 2 testing days. Similar to Study 1, the athletes punched with significantly greater velocities (6 %, p < 0.05) and normalised impact forces (2 %, p < 0.05) in the choice condition. These findings complement research on autonomy support in motor learning by demonstrating immediate advantages in force production and velocity with experienced athletes.