Effects of Attentional Focus Verbal Cues on Trunk Muscle Activation and the Range of Spine Axial Rotation depending on the Skill Level during the Pilates Spine Twist

OBJECTIVES This study examined the effects of attentional focus verbal cues on trunk muscle activation and thoracic rotation range of motion (ROM) during the Pilates Spine Twist exercise, considering participants’ skill level.METHODS Thirty-six healthy adult women (18 experts and 18 novices) performed the Spine Twist under two cueing conditions: external focus of attention (EFA) and internal focus of attention (IFA). Muscle activity of the external and internal oblique muscles, quadratus lumborum, and erector spinae was recorded using surface electromyography (EMG), and thoracic ROM was assessed using a goniometer. A 2 (group) × 2 (focus) mixed-design ANOVA was performed, with the Holm-Bonferroni procedure applied across the four EMG outcomes to control for multiple testing.RESULTS After Holm-Bonferroni correction, significant Focus × Group interaction effects remained for all four trunk muscles (<i>p</i> < 0.05). Bonferroni-adjusted pairwise comparisons showed that EO and IO activation was significantly higher under EFA in experts and under IFA in novices, whereas QL activation showed the opposite pattern (<i>p</i> < 0.05). For ES, no significant pairwise differences between EFA and IFA were observed within either group despite a significant interaction. Thoracic rotation ROM was significantly greater under EFA than IFA regardless of skill level (<i>p</i> < 0.001).CONCLUSIONS These findings suggest that attentional focus may influence trunk muscle activation patterns and thoracic ROM according to skill level and may provide useful information for verbal cueing strategies in Pilates instruction and rehabilitation practice.