AIM: Therapeutic exercises are administered during motor rehabilitation in order to cause long-term motor modifications. During the application of attentional focus strategies, external focus of attention (EFA) aiming at the movement effect has been reported to have more efficacy than internal focus of attention (IFA) aiming at the movement characteristics in healthy subjects. Only few studies compared EFA and IFA in subjects with musculoskeletal or neurological disorders. The aim of this paper was to summarize the results about the comparison of EFA and IFA strategies applied in patients with central nervous system (CNS) and musculoskeletal (MSK) disorders. METHODS: Medline, CINAHL, Embase, PEDro, DARE, and the Cochrane Library were searched from inception to December 2010. Eligible studies should be developed according to RCT or quasi-RCT design, enrolled patients with MSK or CNS disorders, and compared the efficacy of EFA and IFA. Outcomes were considered when related to movement dynamics or movement effects. Further, outcomes should be registered in the retention or in the transfer phase. The critical appraisal was done using the PEDro scale. RESULTS: Weak evidences suggest that EFA has more efficacy than IFA in influencing the execution of motor tasks. Patients with CNS disorders had higher short-term motor performance during reaching and balance tasks. Considering patients with MSK disorders, the long-term motor learning of patients with ankle sprain performing a balance task was higher in those patients treated with EFA. CONCLUSION: Examination findings should be implemented with caution in clinical practice. Further studies should enroll symptomatic subjects in studies with high methodological quality.

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