Focus of Attention During ACL Injury Prevention Exercises Affects Improvements in Jump-Landing Kinematics in Soccer Players: A Randomized Controlled Trial

Context: The best current evidence supports the effectiveness of neuromuscular training in reducing the risk of injury; however, the rate of anterior cruciate ligament (ACL) injuries is still high. Neurocognitive training (NT) has successfully improved biomechanical risk factors, but they have been considered in only a few studies. Objective: To review the literature to determine the effect of NT on biomechanical risk factors related to ACL injury in athletes. Evidence Acquisition: We searched PubMed, Google Scholar, Scopus, Science Direct, and the Physiotherapy Evidence Database from inception to August 2011. We included randomized controlled trials that used motor learning approaches and injury prevention programs to investigate kinematic and kinetic risk factors related to ACL injury. The quality of each clinical trial study was evaluated by the Physiotherapy Evidence Database scale. The eligibility criteria were checked based on the PICOS (population, intervention, comparison, outcome, and study type) framework. Evidence Synthesis: A total of 9 studies were included in the final analysis. Motor learning approaches include internal and external focus of attention, dual tasks, visual motor training, self-control feedback, differential learning, and linear and nonlinear pedagogy, combined with exercise programs. In most of the studies that used NT, a significant decrease in knee valgus; tibial abduction and external rotation; ground reaction force; and an increase in knee-, trunk-, hip-, and knee-flexion moment was observed. Conclusion: In classical NT, deviation from the ideal movement pattern especially emphasizing variability and self-discovery processes is functional in injury prevention and may mitigate biomechanical risk factors of ACL injuries in athletes. Practitioners are advised to use sport-specific cognitive tasks in combination with neuromuscular training to simulate loads of the competitive environment. This may improve ACL injury risk reduction and rehabilitation programs.

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Effects of attentional focus strategies in drop landing biomechanics of individuals with unilateral functional ankle instability

Wang,

Meng,

et al. 2024

Front. Physiol.

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BackgroundFunctional Ankle Instability (FAI) is a pervasive condition that can emerge following inadequate management of lateral ankle sprains. It is hallmarked by chronic joint instability and a subsequent deterioration in physical performance. The modulation of motor patterns through attentional focus is a well-established concept in the realm of motor learning and performance optimization. However, the precise manner in which attentional focus can rehabilitate or refine movement patterns in individuals with FAI remains to be fully elucidated.ObjectiveThe primary aim of this study was to evaluate the impact of attentional focus strategies on the biomechanics of single-leg drop landing movements among individuals with FAI.MethodsEighteen males with unilateral FAI were recruited. Kinematic and kinetic data were collected using an infrared three-dimensional motion capture system and force plates. Participants performed single-leg drop landing tasks under no focus (baseline), internal focus (IF), and external focus (EF) conditions. Biomechanical characteristics, including joint angles, ground reaction forces, and leg stiffness, were assessed. A 2 × 3 [side (unstable and stable) × focus (baseline, IF, and EF)] Repeated Measures Analysis of Variance (RM-ANOVA) analyzed the effects of attentional focus on biomechanical variables in individuals with FAI.ResultsNo significant interaction effects were observed in this study. At peak vertical ground reaction force (vGRF), the knee flexion angle was significantly influenced by attentional focus, with a markedly greater angle under EF compared to IF (p < 0.001). Additionally, at peak vGRF, the ankle joint plantarflexion angle was significantly smaller with EF than with IF (p < 0.001). Significant main effects of focus were found for peak vGRF and the time to reach peak vGRF, with higher peak vGRF values observed under baseline and IF conditions compared to EF (p < 0.001). Participants reached peak vGRF more quickly under IF (p < 0.001). Leg Stiffness (kleg) was significantly higher under IF compared to EF (p = 0.001).ConclusionIF enhances joint stability in FAI, whereas EF promotes a conservative landing strategy with increased knee flexion, dispersing impact and minimizing joint stress. Integrating these strategies into FAI rehabilitation programs can optimize lower limb biomechanics and reduce the risk of reinjury.

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Focus of Attention During ACL Injury Prevention Exercises Affects Improvements in Jump-Landing Kinematics in Soccer Players: A Randomized Controlled Trial

Abstract: Supplemental Digital Content is Available in the Text.

Cited by 4 publications

References 32 publications

Théorie de l’action contrainte comme vecteur d’induction pour optimiser les adaptations biomécaniques de la cinématique d’atterrissage dans la prévention des ruptures du ligament croisé antérieur chez les sportifs : une revue systématique avec méta-analyse

Théorie de l’action contrainte comme vecteur d’induction pour optimiser les adaptations biomécaniques de la cinématique d’atterrissage dans la prévention des ruptures du ligament croisé antérieur chez les sportifs : une revue systématique avec méta-analyse

The Effect of Neurocognitive Training on Biomechanical Risk Factors Related to Anterior Cruciate Ligament Injury in Athletes: A Narrative Review

Effects of attentional focus strategies in drop landing biomechanics of individuals with unilateral functional ankle instability

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