The farther, the better? The effect of attentional focus distance on motor performance: a systematic review and meta-analysis

Background Motor skill performance is influenced by attentional focus, and recent studies suggest that external focus, particularly a more distal external focus, may enhance performance more than an internal or a proximal external focus. However, the optimal distance for external focus and the influence of expertise level remain unclear. This systematic review and meta-analysis aimed to evaluate the effect of attentional focus distance on motor performance across various tasks and expertise levels. Methods This systematic review and meta-analysis followed established guidelines (PRISMA) and was registered with the International Prospective Register of Systematic Reviews (CRD42024595116). Comprehensive literature searches were performed in PubMed, Web of Science, Embase, and Cochrane Library databases. Data extraction followed the PICOS framework, and analyses were conducted using Stata and Review Manager. Results A total of 20 randomized controlled trials with 497 participants were included. The results indicated that a distal external focus significantly improved motor performance compared to both external proximal focus (standardized mean difference, S = 0.3, 95% CI [0.07–0.53], p = 0.01) and internal focus (SMD = 0.59, 95% CI [0.14–1.05], p = 0.01). However, no significant difference was observed between the distal and proximal external focus in novices. Subgroup analyses showed that skill level significantly moderated the effectiveness of attentional focus. Conclusions A distal external focus improves motor performance in experienced although its effectiveness in novices requires further study. Future research should explore the mechanisms underlying these effects and skill-specific guidelines for optimal attentional focus distance.