title: Novel methods of instruction in ACL injury prevention programs, a systematic review.
abstract: Anterior cruciate ligament (ACL) injury prevention programs have been successful in the short term. Motor learning strategies with an internal focus (IF) to body movements have traditionally been utilized, but may be less suitable than an external focus (EF) for the acquisition and control of complex motor skills required for sport. To investigate the available literature and provide an overview of the effect of IF and EF instructions on jump landing technique. Systematic searches were conducted in PubMed (1966 to May 2014), CINAHL (1981 to May 2014) and PsycInfo (1989 to May 2014). A priori defined inclusion criteria were: (i) full text; (ii) published in English, German or Dutch; (iii) healthy adult subjects (mean age ≥18 years); (iv) jump and landing performance tested and (v) study used comparison between an EF and IF. Performance (jump height and distance) and technique (kinematics and kinetics) were the primary outcome variables of interest. Nine papers were included. Significant better motor performance and movement technique was found with an EF compared to an IF. Considering the beneficial results in the included studies when utilizing an EF, it is suggested to implement these strategies into ACL injury prevention programs.
authors.affiliation: University of Groningen, University Medical Center Groningen, Center for Human Movement Science, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; School of Sport Studies, Hanze University Groningen, Zernikeplein 17, 9747 AS, Groningen, The Netherlands. Electronic address: a.benjaminse@umcg.nl.
authors.forename: Anne
authors.initials: A
authors.lastname: Benjaminse
authors.affiliation: University of Groningen, University Medical Center Groningen, Center for Human Movement Science, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands. Electronic address: w.welling@student.rug.nl.
authors.forename: Wouter
authors.initials: W
authors.lastname: Welling
authors.affiliation: University of Groningen, University Medical Center Groningen, Center for Human Movement Science, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands. Electronic address: e.otten@umcg.nl.
authors.forename: Bert
authors.initials: B
authors.lastname: Otten
authors.affiliation: University of Groningen, University Medical Center Groningen, Center for Human Movement Science, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands. Electronic address: a.gokeler@rug.nl.
authors.forename: Alli
authors.initials: A
authors.lastname: Gokeler
mesh_terms: D000070598:Anterior Cruciate Ligament Injuries; D001265:Athletic Injuries / Q000517:prevention & control*; D001696:Biomechanical Phenomena; D006801:Humans; D007718:Knee Injuries / Q000517:prevention & control*; D010806:Physical Education and Training / Q000379:methods*
keywords: ACL injury prevention; External focus; Jumping performance; Motor learning