The Effect of Different Instruction Trainings in Semi-Professional Female Athletes

NCT ID: NCT06424886

Last Updated: 2024-06-13

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 30 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-01-15
• Study Completion Date: 2024-06-12

Brief Summary

Feedback is implanted into workouts to prevent lower extremity injuries. There are different studies where external focus and internal focus feedback were found to be superior. The main purpose of this study is to investigate the effects of training on vertical jump landing technique by comparing a verbal training group that receives instructions with an external focus of attention and an internal focus of attention combined, a visual training group with video instructions, and a control group in female athletes with knee valgus. It is also to examine whether possible beneficial results are still present in the retention test performed one week after the test session. The secondary aim of our study is to examine the effect of the training provided on knee joint position sense.

Detailed Description

Approximately 70% of lower extremity injuries occur during non-contact, single-leg landings, and jumping to the ground is a common injury mechanism in both genders. Additionally, female athletes have higher injury rates compared to men, potentially due to anatomical differences of the lower kinematic chain. Events in which athletes experience non-contact ACL injuries generally show many common biomechanical features such as increased ground reaction forces during single-leg landing, decreased joint flexion in the sagittal plane of the ankle, knee, hip and trunk, as well as increased knee internal rotation angles. Another critical ACL injury risk factor is performing a secondary task during sharp deceleration movements. Current rehabilitation programs focus on neuromuscular training programs to prevent adverse movement patterns and increase proper movement control. However, there is still a need to increase the effectiveness of these neuromuscular training programs to have a more significant impact on ACL injury rates. Therefore, the use of motor learning strategies and neuromuscular training programs with adequate and correct techniques in the rehabilitation of athletes should still be investigated.

There are various approaches to motor learning. One of the best-known approaches is the cognitive approach, where the athlete reaches the automation stage by receiving feedback and repeating the model technique as often as possible. The common denominator of motor learning strategies is the use of explicit instructions and feedback regarding desired landing positions. Instructions for the implementation of movements in rehabilitation programs aim to improve performance and motor learning. These instructions may address the action outcome or the course of action. There are many studies showing that feedback training changes jump landing biomechanics. In line with the results of these studies, using feedback techniques, especially to reduce the vertical ground reaction force and increase the knee flexion angle during landing from a jump, can reduce the stress and risk of injury in the lower extremity.

Motor skills can be learned with an internal focus of attention or with an external focus of attention. Although the difference in these instructions may seem insignificant, externally focused education; has been shown to result in better performance, retention, transfer, and greater movement automaticity. The main purpose of this study is to investigate the effects of training on vertical jump landing technique by comparing a verbal training group that receives instructions with an external focus of attention and an internal focus of attention combined, a visual training group with video instructions, and a control group in female athletes with knee valgus. It is also to examine whether possible beneficial results are still present in the retention test performed one week after the test session. The secondary aim of our study is to examine the effect of the training provided on knee joint position sense.

Conditions

Injury;Sports

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: PREVENTION
• Blinding Strategy: SINGLE

Study Groups

Video Instructed Training Group

Before the study is conducted, the expert video that will be used for the VI group instructions will be created. The expert video will be created with an athlete with a LESS score of less than 4 and an FPPA of less than 100 who performs a DVJ task in accordance with the instructions. A video recording will be taken of the person designated as an expert performing the DVJ task. The video recording will be used only for the VI group instructions.

Group Type: EXPERIMENTAL

Landing error scoring system (LESS)

Intervention Type: OTHER

Each group will perform two training blocks of 10 drop vertical jumping (DVJ) tasks. Knee joint position sense (KJPS), frontal plane projection angle (FPPA), and Landing Error Scoring System (LESS) assessments will be performed before and after the training blocks, and follow-up assessments will be performed 1 week later. The dominant limb of the participants (the side limb they use when kicking the ball) will be taken into account during the measurement.

Verbal Combined Focus Instructed Training Group

It was emphasized that the participants should jump from the 30 cm high box and immediately after landing, jump as high and forward as possible and maintain the final landing stance for 5 seconds. Participants were asked to perform 5 drop vertical jumps and the jumps performed were evaluated. After pretest evaluations were recorded, verbal training group participants performed two training blocks, receiving instructions specific to their group. Participants were given a combined verbal instruction such as "Focus on how hard you push yourself off the ground after the jump and how quickly you straighten your knees during this push", in which internal and external focus directions were given simultaneously. After receiving the instructions, the participants performed 2 drop vertical jumps, 10 times each.

Group Type: EXPERIMENTAL

Landing error scoring system (LESS)

Intervention Type: OTHER

Each group will perform two training blocks of 10 drop vertical jumping (DVJ) tasks. Knee joint position sense (KJPS), frontal plane projection angle (FPPA), and Landing Error Scoring System (LESS) assessments will be performed before and after the training blocks, and follow-up assessments will be performed 1 week later. The dominant limb of the participants (the side limb they use when kicking the ball) will be taken into account during the measurement.

Control Group

Participants will be explained how to do the DVJ task in the same way as other groups. Then, after the participants' measurements will be taken, they will start the training blocks without any instructions. Participants will not receive any feedback during training blocks.

Group Type: EXPERIMENTAL

Landing error scoring system (LESS)

Intervention Type: OTHER

Each group will perform two training blocks of 10 drop vertical jumping (DVJ) tasks. Knee joint position sense (KJPS), frontal plane projection angle (FPPA), and Landing Error Scoring System (LESS) assessments will be performed before and after the training blocks, and follow-up assessments will be performed 1 week later. The dominant limb of the participants (the side limb they use when kicking the ball) will be taken into account during the measurement.

Interventions

Landing error scoring system (LESS)

Each group will perform two training blocks of 10 drop vertical jumping (DVJ) tasks. Knee joint position sense (KJPS), frontal plane projection angle (FPPA), and Landing Error Scoring System (LESS) assessments will be performed before and after the training blocks, and follow-up assessments will be performed 1 week later. The dominant limb of the participants (the side limb they use when kicking the ball) will be taken into account during the measurement.

Intervention Type: OTHER

Other Intervention Names

drop vertical jump landing task; frontal plane projection angle (FPPA); knee joint position sense (KJPS)

Eligibility Criteria

Inclusion Criteria

• Being female
• Being between the ages of 18-24
• Body mass index being between 18.5 kg/m2 and 25 kg/m2
• Becoming a minor league basketball or volleyball player
• Volunteers must not have suffered any trunk or lower extremity injuries in the last 6 months before participation in the study.
• Having a frontal plane projection angle greater than 100 during the single-leg squat test

Exclusion Criteria

• • Having experienced a trunk or lower extremity injury in the last 6 months before the date of study

• Having a history of fracture or dislocation in the lower extremity
• Having suffered from back pain in the past years
• Having a musculoskeletal system abnormality
• Being unable to perform functional tasks (visual, auditory, vestibular or neurological impairment)
• Being pregnant
• Having malignancy and metabolic diseases

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 24 Years
• Eligible Sex: FEMALE
• Accepts Healthy Volunteers: Yes

Sponsors

Bahçeşehir University

OTHER

Sponsor Role: lead

Responsible Party

Pelin Pişirici

Assistant Professor, PT, PhD

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Pelin Pişirici, PT, PhD

Role: STUDY_DIRECTOR

Bahcesehir University, Faculty of Health Sciences, Department of Physiotherapy

Büşra Tamgüç, PT

Role: PRINCIPAL_INVESTIGATOR

Bahcesehir University, Graduate Education Institute

Locations

Istanbul Panterler Sports Club

Kağıthane, Istanbul, Turkey (Türkiye)

Countries

Turkey (Türkiye)

References

Tamguc B, Pisirici P. The Effect of Verbal Combined Focus of Attention and Video Instruction Training on Knee Valgus and Landing Technique in Semiprofessional Female Athletes. Orthop J Sports Med. 2025 Apr 4;13(4):23259671251326454. doi: 10.1177/23259671251326454. eCollection 2025 Apr.

Reference Type: DERIVED

PMID: 40291630 (View on PubMed)

Other Identifiers

BT-FocusT

Identifier Type: -

Identifier Source: org_study_id