The Gender-Specific Effect of Different Instruction Training

NCT ID: NCT06746454

Last Updated: 2025-01-03

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 48 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-11-05
• Study Completion Date: 2024-12-20

Brief Summary

Feedback is incorporated into training programs to prevent injuries. The superiority of several feedback techniques is still debated and there is a need for gender specific studies. The main aim of the study was to investigate the gender-specific effectiveness of two different feedback techniques (combined verbal training with internal and external focus feedback and video training with instructional feedback) on the landing technique after vertical jump, frontal plane projection angle, and joint position sense in male and female volleyball players with asymptomatic knee valgus. In addition, the continuity of potential positive results in a retention test performed one week after the test session will be evaluated.

Detailed Description

Prevention of knee injuries in sports, especially in contact sports, is important for both the health of the athlete and the success of the team. Volleyball injuries are seen in the knee region with a rate of 23.66%. Jumping to the ground is a common injury mechanism in both genders.

The anatomical and physiological differences of young athletes make them more prone to these injuries. Anatomical variations, hormonal effects, and neuromuscular control problems are among the factors that increase the likelihood of these injuries.

Male athletes are considered to be prone to ACL injuries due to hormonal changes that occur during puberty. Furthermore, it has been reported that men are more frequently exposed to ankle and knee injuries in sports such as volleyball.

In terms of female athletes, it has been observed that hormonal fluctuations may increase the risk of injury by affecting the structure and durability of connective tissue. It has been stated that changes in various hormones during the menstrual cycle cause ligaments to become looser. This is a factor that increases the risk of injury during physical activities.

Current rehabilitation programs focus on neuromuscular training programs to prevent negative movement patterns and increase proper movement control. Neuromuscular training programs are exercise approaches that aim to improve skills such as motor control, strength, balance, coordination, and proprioception. These programs strengthen balance and stability, especially in the lower extremities, allowing athletes to perform movements such as sudden changes of direction, jumping, and landing more safely.

However, there is 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 still needs to be investigated.

The incorporation of feedback instructions into injury programs is frequently reported in the current literature, and the common denominator that studies have found is the use of clear directives and specific instructions regarding the desired landing position.

Motor skills can be learned with an internal focus of attention or with an external focus of attention. Although the difference between these instructions may seem insignificant, externally focused training has resulted in better performance, retention, transfer and greater movement automaticity. Furthermore, other studies have shown that internal focus of attention instructions are superior to external focus of attention in motor learning in various disciplines. Recent literature highlights the necessity of using both feedback techniques at the same time as combined.

Observation is an effective method to improve motor skill learning. Observing the data given with video feedback and imitating it by copying the body movements. The usage of video feedback is beneficial by contributing to lower limb dynamics during landing movements after jumping. Further studies are needed to examine the effect of video feedback on different genders.

The main aim of the study was to investigate the gender-specific effectiveness of two different feedback techniques (combined verbal training with internal and external focus feedback and video training with instructional feedback) on the landing technique after the vertical jump, frontal plane projection angle, and joint position sense in male and female volleyball players with asymptomatic knee valgus.

However, there is 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 still needs to be investigated.

The incorporation of feedback instructions into injury programs is frequently reported in the current literature, and the common denominator that studies have found is the use of clear directives and specific instructions regarding the desired landing position.

Motor skills can be learned with an internal focus of attention or with an external focus of attention. Although the difference between these instructions may seem insignificant, externally focused training has been shown to result in better performance, retention, transfer, and greater movement automaticity. Furthermore, other studies have shown that the internal focus of attention instructions is superior to the external focus of attention in motor learning in various disciplines. Recent literature highlights the necessity of using both feedback techniques at the same time as combined.

Observation is an effective method to improve motor skill learning. Observing the data given with video feedback and imitating it by copying the body movements. The usage of video feedback is beneficial by contributing to lower limb dynamics during landing movements after jumping. Further studies are needed to examine the effect of video feedback on different genders.

The main aim of the study was to investigate the gender-specific effectiveness of two different feedback techniques (combined verbal training with internal and external focus feedback and video training with instructional feedback) on the landing technique after the vertical jump, frontal plane projection angle, and joint position sense in male and female volleyball players with asymptomatic knee valgus.

Conditions

Sports Injury

Study Design

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

Study Groups

Video Instructed Training Group

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 was created with an athlete with a LESS score of less than 4 and an FPPA of less than 10 who performs a DVJ task following the instructions. The video recording was used only for the video group instructions.

Group Type: EXPERIMENTAL

Video Instructed Training Group

Intervention Type: OTHER

"Pre-test" measurements were taken to determine the baseline values of the athletes before the training packages specific to their group. The pre-test measurements included a landing error scoring system, knee position error sense, and frontal plane projection angle. After the pre-test measurements, 2 training packages with special instructions were performed for the video instructed training (VIT) group. The special instruction for the VIT group included a previously prepared video of a successful vertical jump landing task. This video was shown to the VIT group. Immediately after the training packages, post-test measurements were taken. The post-test measurements included the same tests as the pre-test measurements. A follow-up test was taken 7 days after the measurements. The follow-up test included the same measurements as in the pre-test and post-test phases.

Verbal Combined Focus Instructed Training Group

Participants will be given 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.

Group Type: EXPERIMENTAL

Verbal Combined Focus Instructed Training Group

Intervention Type: OTHER

"Pre-test" measurements were taken to determine the baseline values of the athletes before the training packages specific to their group. The pre-test measurements included landing error scoring system, knee position error sense, and frontal plane projection angle. After the pretest measurements, 2 training packages with specific instructions were performed for the CSE group. The special instruction given to the CSE group consisted of the following sentence, which included the both internal and external focus of attention; "focus on how hard you push yourself off the ground and how fast you straighten your knees during this push-off". Immediately after the training packages, post-test measurements were taken. The post-test measurements included the same tests as the pre-test measurements. A follow-up test was taken 7 days after the measurements. The follow-up test included the same measurements as in the pre-test and post-test phases.

Interventions

Video Instructed Training Group

"Pre-test" measurements were taken to determine the baseline values of the athletes before the training packages specific to their group. The pre-test measurements included a landing error scoring system, knee position error sense, and frontal plane projection angle. After the pre-test measurements, 2 training packages with special instructions were performed for the video instructed training (VIT) group. The special instruction for the VIT group included a previously prepared video of a successful vertical jump landing task. This video was shown to the VIT group. Immediately after the training packages, post-test measurements were taken. The post-test measurements included the same tests as the pre-test measurements. A follow-up test was taken 7 days after the measurements. The follow-up test included the same measurements as in the pre-test and post-test phases.

Intervention Type: OTHER

Verbal Combined Focus Instructed Training Group

"Pre-test" measurements were taken to determine the baseline values of the athletes before the training packages specific to their group. The pre-test measurements included landing error scoring system, knee position error sense, and frontal plane projection angle. After the pretest measurements, 2 training packages with specific instructions were performed for the CSE group. The special instruction given to the CSE group consisted of the following sentence, which included the both internal and external focus of attention; "focus on how hard you push yourself off the ground and how fast you straighten your knees during this push-off". Immediately after the training packages, post-test measurements were taken. The post-test measurements included the same tests as the pre-test measurements. A follow-up test was taken 7 days after the measurements. The follow-up test included the same measurements as in the pre-test and post-test phases.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Being between the ages of 18-24
• Becoming a minor 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 10° 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: ALL
• 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

Oktay Şenozan, PT

Role: PRINCIPAL_INVESTIGATOR

Bahcesehir University, Graduate Education Institute, Physiotherapy and Rehabilitation, Master of Science Program

Pelin Pişirici, PT, PhD

Role: STUDY_DIRECTOR

Bahcesehir University, Faculty of Health Sciences

Locations

Smyrna Sports Club

Izmir, , Turkey (Türkiye)

Countries

Turkey (Türkiye)

Other Identifiers

OS-GenderF

Identifier Type: -

Identifier Source: org_study_id