***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Purpose Adding external focus of attention ( EF , focus on the movement effect ) may optimize current anterior cruciate ligament ( ACL ) injury prevention programmes . The purpose of the current study was to investigate the effects of an EF , by a visual stimulus and an internal focus , by a verbal stimulus during unexpected sidestep cutting in female and male athletes and how these effects remained over time . Methods Ninety experienced basketball athletes performed sidestep cutting manoeuvres in three sessions ( S1 , S2 and S3 ) . In this r and omized controlled trial , athletes were allocated to three groups : visual ( VIS ) , verbal ( VER ) and control ( CTRL )  . Kinematics and kinetics were collected at the time of peak knee frontal plane moment . Results Males in the VIS group showed a larger vertical ground reaction force ( S1 : 25.4 ± 3.1 N/kg , S2 : 25.8 ± 2.9 N/kg , S3 : 25.2 ± 3.2 N/kg ) and knee flexion moments ( S1 : −3.8 ± 0.9 Nm/kg , S2 : −4.0 ± 1.2 Nm/kg , S3 : −3.9 ± 1.3 Nm/kg ) compared to the males in the VER and CTRL groups and to the females in the VIS group ( p < 0.05 ) . Additionally , the males in the VIS group reduced knee valgus moment and the females in the VER group reduced knee varus moment over time ( n.s . ) . Conclusion Male subjects clearly benefit from visual feedback . Females may need different feedback modes to learn a correct movement pattern . Sex-specific learning preferences may have to be acknowledged in day by day practice . Adding video instruction or feedback to regular training regimens when teaching athletes safe movement patterns and providing individual feedback might target suboptimal long-term results and optimize ACL injury prevention programmes . Level of evidence The aim of this study was to ascertain whether the performances of implicit and explicit learners would converge over an extended period of learning . Participants practised a complex motor skill - golf putting - for 3000 trials , either with a concurrent secondary , tone-counting task ( implicit learning ) or without such a task ( explicit learning ) . The cognitive dem and s of the secondary task were predicted to prevent the accumulation of verbalizable rules about the motor task . The implicit group reported significantly fewer rules than the explicit group on subsequent verbal protocol s. The performance of the implicit group remained below that of the explicit group throughout the learning phase . However , no significant differences were found between groups during a delayed retention test . Additionally , for the participants in the explicit group only , a Reinvestment Scale score correlated positively with the number of rules accrued and negatively with overall putting performance during the learning phase . We use the results to argue against the excessive use of verbal instruction during skill acquisition , which might be unnecessary and ultimately might hamper performance under stressful conditions Accumulating evidence suggests that instructions inducing an " external " focus ofattention by directing learners ' attention toward the effects of their movements enhance learning , compared to instructions directing attention to the movements themselves ( " internal " focus ; for a review , see Wulf & Prinz , 2001 ) . Wulf , HoB , and Prinz ( 1998 ) first demonstrated external relative to internal focus advantages using  ski-simulator and stabilometer tasks . In subsequent studies , this effect proved to be quite robust ( e.g. , Shea & Wulf , 1999 ; Wulf , McNevin , & Shea , 2001 ) and generalizable to sports-related tasks , including golf ( Wulf , Lauterbach , & Toole , 1999 ) , tennis ( Wulf , McNevin , Fuchs , Ritter , & Toole , 2000 ) , soccer , and volleyball skills ( Wulf , McConnel , Gartner , & Schwarz , 2002 ) . A " constrained action hypothesis " ( Wulfet aI. , 2001 ) was proposed to account for the greater effectiveness of an external compared to  internal focus ofattention . According to this hypothesis , attempts to control one 's own movements consciously ( internal focus ) disrupt functioningofthe motor system by interferingwith automatic control processes . In contrast , focusing on the effects ofone 's movements promotes the use of automatic control processes , allowing the motor system to self-organize more naturally . The study by Wulf et al. ( 2001 ) supported this viewby demonstrating not only faster and more frequent adjustments of the balance movements but also Implicit processes almost certainly preceded explicit processes in our evolutionary history , so they are likely to be more resistant to disruption according to the principles of evolutionary biology [ Reber , A. S. ( 1992 ) . The cognitive unconscious : An evolutionary perspective . Consciousness and Cognition , 1 , 93 - 133 . ] . Previous work ( e.g. , [ Masters , R. S. W. ( 1992 ) . Knowledge , (k)nerves and know-how : The role of explicit versus implicit knowledge in the breakdown of a complex motor skill under pressure . British Journal of Psychology , 83 , 343 - 358 . ] ) has shown that implicitly learned motor skills remain stable under psychological pressure and concurrent cognitive dem and s , and recently [ Poolton , J. M. , Masters , R. S. W. , & Maxwell , J. P. ( 2007 ) . Passing thoughts on the evolutionary stability of implicit motor behaviour : Performance retention under physiological fatigue . Consciousness and Cognition , 16(2 ) , 456 - 468 . ] showed that they also remain stable under conditions of anaerobic fatigue that would have significantly challenged the survival skills of our ancestors . Here we examine the stability of an implicitly learned motor skill  under fatigue conditions that primarily tax a different physiological system ( the aerobic system ) , but which have equally strong evolutionary connotations . Participants acquired a throwing task by means of an errorless ( implicit ) learning method or an errorful ( explicit ) method .  Motor performance in the errorless condition , but not the errorful condition , remained stable following an exhaustive VO2 max . running test . Our findings replicate and extend the work of Poolton et al. , providing further support for Reber 's evolutionary distinction between implicit and explicit processes OBJECTIVES A growing number of publications describe cerebellar abnormalities in patients with bipolar disorder ( BD ) . The aim of the following paper was to examine the functional aspects of that issue by focusing on implicit learning - a cognitive function with significant cerebellar underpinnings . METHODS 27 patients with BD and 26 healthy controls ( HC ) , matched for age and sex took part in the study .  Implicit motor learning was assessed by the serial reaction time task ( SRTT ) , in which participants were unconsciously learning a sequence of motor reactions . The indicators of procedural learning were the decrease of reaction time ( RT ) across the repetition of the sequence and the rebound of RT when the sequence changed into a r and om set of stimuli . RESULTS BD patients did not present any indicators of the implicit learning , their RT increased across repetitions of the sequence and it decreased when the sequence changed to r and om . Contrary , in the control group RT decreased across the sequence repetitions and increased when the stimuli begun to appear r and omly . LIMITATIONS A low subject count and a non-drug naïve patients group , medicated with atypical antipsychotic and mood stabilizers , are the most significant limitations of this study . CONCLUSIONS BD patients did not acquire procedural knowledge while performing the task , whereas HC did . To our knowledge this is the first study that shows the impairment of implicit motor learning in patients with BD . This indicates the possible cerebellar dysfunction in this disease and may provide a new neuropsychiatric approach to bipolar disorder Overwhelming evidence shows the quality of reporting of r and omised controlled trials ( RCTs ) is not optimal . Without transparent reporting , readers can not judge the reliability and validity of trial findings nor extract information for systematic review s. Recent method ological analyses indicate that inadequate reporting and design are associated with biased estimates of treatment effects . Such systematic error is seriously damaging to RCTs , which are considered the gold st and ard for evaluating interventions because of their ability to minimise or avoid bias . A group of scientists and editors developed the CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to improve the quality of reporting of RCTs . It was first published in 1996 and up date d in 2001 . The statement consists of a checklist and flow diagram that authors can use for reporting an RCT . Many leading medical journals and major international editorial groups have endorsed the CONSORT statement . The statement facilitates critical appraisal and interpretation of RCTs . During the 2001 CONSORT revision , it became clear that explanation and elaboration of the principles underlying the CONSORT statement would help investigators and others to write or appraise trial reports . A CONSORT explanation and elaboration article was published in 2001 alongside the 2001 version of the CONSORT statement . After an expert meeting in January 2007 , the CONSORT statement has been further revised and is published as the CONSORT 2010 Statement . This up date improves the wording and clarity of the previous checklist and incorporates recommendations related to topics that have only recently received recognition , such as selective outcome reporting bias . This explanatory and elaboration document-intended to enhance the use , underst and ing , and dissemination of the CONSORT statement-has also been extensively revised . It presents the meaning and rationale for each new and up date d checklist item providing examples of good reporting and , where possible , references to relevant empirical studies . Several examples of flow diagrams are included . The CONSORT 2010 Statement , this revised explanatory and elaboration document , and the associated website ( www.consort-statement.org ) should be helpful re sources to improve reporting of r and omised trials Abstract We investigated the attention dem and s associated with implicit and explicit ( motor ) learning and performance using a probe reaction time paradigm . Two groups of participants learned a golf putting task  over eight blocks of 50 trials performed from different distances . One group ( errorless learning )  began putting from the shortest distance ( 25 cm ) and moved progressively back to the furthest distance ( 200 cm ) . A second group ( errorful learning )  began putting from the furthest distance ( 200 cm ) and moved progressively closer ( 25 cm ) . Retention tests were used to assess learning in the two conditions , followed by transfer tests in which participants used either an unusual putter or a very unusual putter . Transfer to the unusual putters had an equivalent effect on the performance of both errorless and errorful learners , but probe reaction times were unaffected in the errorless learners , suggesting that execution of their movements was associated with reduced attention dem and s. Reducing errors during initial learning trials may encourage an implicit mode of learning and lower the dem and for cognitive re sources in subsequent performance 
    Output:
    
Most comparisons did not show group differences .
Conclusions Most comparisons did not show group differences in automaticity .
The remaining comparisons leaned more toward a greater degree of movement automaticity after implicit learning than explicit learning .