Altered trunk and lower extremity movement coordination after neuromuscular training with and without external focus instruction: a randomized controlled trial

Abstract

Background This study sought to determine the effects of a 6-week neuromuscular training (NMT) and NMT plus external focus (NMT plus EF) programs on trunk and lower extremity inter-segmental movement coordination in active individuals at risk of injury. Methods Forty-six active male athletes (controls = 15, NMT = 16, NMT plus EF = 15) participated (age = 23.26 ± 2.31 years) in this controlled, laboratory study. Three-dimensional kinematics were collected during a drop vertical jump (DVJ). A continuous relative phase (CRP) analysis quantified inter-segmental coordination of the: (1) thigh (flexion/extension)—shank (flexion/extension), (2) thigh (abduction/adduction)—shank (flexion/extension), (3) thigh (abduction/adduction)—trunk (flexion/extension), and (4) trunk (flexion/extension)—pelvis (posterior tilt/anterior tilt). Analysis of covariance compared biomechanical data between groups. Results After 6 weeks, inter-segmental coordination patterns were significantly different between the NMT and NMT plus EF groups (p < 0.05). No significant differences were observed in CRP for trunk-pelvis coupling comparing between NMT and NMT plus EF groups (p = 0.134), while significant differences were observed CRP angle of the thigh-shank, thigh-trunk couplings (p < 0.05). Conclusions Trunk and lower extremity movement coordination were more in-phase during DVJ in the NMT plus EF compared to NMT in active individuals at risk of anterior cruciate ligament injury. Trial registration: The protocol was prospectively registered at UMIN_RCT website with ID number: UMIN000035050, Date of provisional registration 2018/11/27.

Effect of combining eight weeks of neuromuscular training with dual cognitive tasks on landing mechanics in futsal players with knee ligament dominance defect: a randomized controlled trial

“…The human body is considered an inter-connected kinetic chain in which compensation movements or defects in one area cause functional defects in other parts of the body [ 49 ]. In fact, the movements of a joint are affected by the adjacent joints and affect them as well [ 50 ]. Biomechanical patterns that increase the DKV, decrease hip, knee, and trunk flexion, excessive trunk lateral flexion, and ankle dorsiflexion limitation increase the risk of ACL injury [ 5 ].…”

Acute and Long-Term Effects of Attentional Focus Strategies on Muscular Strength: A Meta-Analysis

“…These studies have generally demonstrated that adopting an external focus of attention is beneficial for the performance of tasks in different sports such as golf, rowing, and basketball [3][4][5]. Research in the field also explored the effects of attentional focus strategies on movement coordination and landing biomechanics in athletes with anterior cruciate ligament reconstruction [6,7].…”

Comparing the Effects of Differential Learning, Self-Controlled Feedback, and External Focus of Attention Training on Biomechanical Risk Factors of Anterior Cruciate Ligament (ACL) in Athletes: A Randomized Controlled Trial

“…Inclusion criteria included athletes in three sports (handball, volleyball, and basketball), and (a) dynamic knee valgus more than 10 degrees during single-leg landing [ 13 ], (b) no injury to the trunk and lower extremity during the last six months, (c) age 20 to 25 years, and (d) BMI between 18.5–25 kg/m 2 . Exclusion criteria were: musculoskeletal abnormalities, history of fracture or dislocation of the hip, knee and ankle, history of lower back pain in the past year, and inability to perform functional tasks (visual and/or hearing, vestibular, and neurological impairments) [ 25 , 47 ].…”