An interdisciplinary examination of attentional focus strategies used during running gait retraining

The aim was to investigate the biomechanical, physiological and perceptual responses to different motor learning strategies derived to elicit a flatter foot contact. Twenty-eight, rearfoot striking recreational runners (age: 24.9±2.8 years; body mass 78.8±13.6 kg; height 1.79±0.09 m) were matched by age, mass and height and assigned to one verbal cue group: internal focus of attention (IF), external focus of attention (EF) and a clinically derived condition (CLIN) incorporating an IF statement followed by an EF statement. Participants completed two treadmill runs at 10 km.h-1 for six minutes each, first normal running (control) followed by the experimental condition (IF, EF or CLIN). Lower limb kinematics, oxygen consumption (푉̇푂2) and central and peripheral ratings of perceived exertion (RPE) were recorded for each run. Foot angle was reduced in the IF condition (difference=5.86°, d=1.12), but unchanged in the EF (difference=0.33°, d=0.11) and CLIN (difference=3.00°, d=0.73) conditions. The EF and CLIN conditions produced greater knee flexion at initial contact compared to control (difference=-5.19°, d=1.21; difference=-3.66°, d=1.81, respectively). A higher 푉̇푂2 was observed in the CLIN condition (difference=-4.56 ml.kg-1.min-1, d=1.00) whilst there was no change in the IF (difference = -1.87 ml.kg-1.min-1, d=1.53) or EF conditions (difference=-0.37 ml.kg-1.min-1, d=0.12). Central and peripheral RPE were higher across all experimental conditions (difference=-0.96, d=0.68 and difference=-2.39, d=1.23 respectively). Providing gait retraining instructions using an internally directed focus of attention was the most effective way to target specific changes in running kinematics, with no detrimental effect on physiological responses. Yet, perceptual effort responses increased regardless of the type of cue provided.