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. 2017 Nov;12(6):908-920.

RETENTION OF MOVEMENT TECHNIQUE: IMPLICATIONS FOR PRIMARY PREVENTION OF ACL INJURIES

Wouter Welling, Anne Benjaminse, Alli Gokeler  1 , Bert Otten  1
Affiliations

RETENTION OF MOVEMENT TECHNIQUE: IMPLICATIONS FOR PRIMARY PREVENTION OF ACL INJURIES

Wouter Welling et al. Int J Sports Phys Ther. 2017 Nov.

Abstract

Background: Retention of movement technique is crucial in anterior cruciate ligament (ACL) injury prevention programs. It is unknown if specific instructions or video instructions result in changes in kinematic and kinetic measures during a relatively short training session, and in a retention test one week later.

Hypothesis/purpose: The purpose was to determine the effects of verbal external focus (EF), verbal internal focus (IF) and video instructions (VI) on landing technique (i.e. kinematics and kinetics) during training and retention.

Study design: Randomized Controlled Trial.

Methods: This study compared verbal EF, verbal IF, VI and CTRL group. Forty healthy athletes were assigned to the IF (n=10), EF (n=10), VI (n=10) or CTRL group (n=10). A jump-landing task was performed as a baseline, followed by two training blocks (TR1 and TR2) and a post test. Group specific instructions were offered in TR1 and TR2. In addition, subjects in the IF, EF and VI groups were free to ask for feedback after every jump in TR1 and TR2. One week later, a retention test was conducted without specific instructions or feedback. Kinematics and kinetics were captured using an 8-camera motion analysis system.

Results: Males and females in the EF and VI instruction group showed beneficial results during and after the training session, in terms of improved landing technique. Retention was achieved after only a short training session.

Conclusion: ACL injury prevention programs should include EF and/or VI instructions to improve kinematics and kinetics and achieve retention.

Level of evidence: 3b.

Keywords: Injury prevention; motor learning; movement technique; retention.

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Figures

Figure 1
Figure 1
CONSORT flow chart, including data analysis. EF = external focus; IF = internal focus; VI = video; CTRL = control group; TR1 = training block 1; TR2 = training block 2
Figure 2
Figure 2
Subjects jumped from a 30-cm high box to a distance of 50% of their height away from the box, down to the two force plates on the ground, and immediately rebounded for a maximal vertical jump on landing as originally described in the Landing Error Scoring System procedures.
Figure 3.
Figure 3.
Graphical representation of knee flexion angles (°) in males. ° = degrees; D = dominant leg; ND = non-dominant leg; EF = external focus group; IF = internal focus group; VI = video group; CTRL = control group; TR1 = training block 1; TR2 = training block 2.
Figure 4.
Figure 4.
Graphical representation of knee flexion angles (°) in females. ° = degrees; D = dominant leg; ND = non-dominant leg; EF = external focus group; IF = internal focus group; VI = video group; CTRL = control group; TR1 = training block 1; TR2 = training block 2.
Figure 5.
Figure 5.
Graphical representation of knee flexion moments (Nm/kg) in males. Nm = Newton meter; kg = kilogram; D = dominant leg; ND = non-dominant leg; EF = external focus group; IF = internal focus group; VI = video group; CTRL = control group; TR1 = training block 1; TR2 = training block 2.
Figure 6.
Figure 6.
Graphical representation of knee flexion moments (Nm/kg) in females. Nm = Newton meter; kg = kilogram; D = dominant leg; ND = non-dominant leg; EF = external focus group; IF = internal focus group; VI = video group; CTRL = control group; TR1 = training block 1; TR2 = training block 2.
Figure 7.
Figure 7.
Graphical representation of knee valgus moments (Nm/kg) in males. Nm = Newton meter; kg = kilogram; D = dominant leg; ND = non-dominant leg; EF = external focus group; IF = internal focus group; VI = video group; CTRL = control group; TR1 = training block 1; TR2 = training block 2.
Figure 8.
Figure 8.
Graphical representation of knee valgus moments (Nm/kg) in females. Nm = Newton meter; kg = kilogram; D = dominant leg; ND = non-dominant leg; EF = external focus group; IF = internal focus group; VI = video group; CTRL = control group; TR1 = training block 1; TR2 = training block 2.
Figure 9.
Figure 9.
Graphical representations of vGRF (N/kg) values in males and females. N = Newton; kg = kilogram; vGRF = vertical ground reactions force; EF = external focus group; IF = internal focus group; VI = video group; CTRL = control group; TR1 = training block 1; TR2 = training block 2.
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