Effects of External and Internal Focus of Attention Exercises in Chronic Low Back Pain: A Randomized Controlled Trial

Abstract

Aim: Balance, physical performance, and functional parameters are adversely affected in individuals with chronic low back pain (CLBP). The focus of attention can affect balance and performance. Our aim is to compare the effects of focus of attention instructions given to dynamic balance exercises on balance, physical performance, and functional status in individuals with CLBP. Design: A randomized controlled trial. Methods: Of 53 individuals with CLBP, 44 individuals who met the inclusion criteria were divided into two groups: the external focus group (EFG) and the internal focus group (IFG). Traditional physiotherapy methods and dynamic balance exercises were applied to both groups. External focus (EF) instructions were given to the EFG, and internal focus (IF) instructions were given to the IFG during the dynamic balance exercises. Participants before and after the treatment were evaluated for pain, functional level, balance, physical performance, and posture. Results: The results of the study showed greater improvement in EFG on dynamic balance, fall risk, stability limits, physical performance, posture, spinal mobility, and postural endurance (p < .05). Conclusions: This study showed that external focusing was more effective than internal focusing on balance, performance, and posture in individuals with CLBP.