Abstract
Background/Objectives: Attentional focus, wherein motor performance differs between internal focus (IF), which directs attention to body parts, and external focus (EF), which directs attention to the external environment, has exhibited a dominance that enhances performance in healthy participants, whereby IF-dominant and EF-dominant groups show higher performance under IF and EF conditions, respectively. In this cross-sectional study, we aimed to verify the dominance of attentional focus in sitting postural control among patients with stroke and explored the involvement of the disconnectome in the dominance of attentional focus. Methods: Stroke survivors performed sitting postural control tasks under IF and EF conditions to evaluate attentional focus dominance. The severity of white matter disconnection was calculated using brain imaging analysis and compared between the IF-dominant and EF-dominant groups. Results: The results showed a dominance of attentional focus in sitting postural control in patients with stroke. Performance in the IF condition influenced the dominance of attentional focus. The EF-dominant group exhibited a higher disconnection severity in the corticostriatal tract (posterior). Conclusions: This study highlights the importance of customized interventions based on the dominance of attentional focus to improve sitting postural control abilities in patients with stroke.