Motor learning
strategies in basketball players and its implications for ACL injury
prevention: a randomized controlled trial
A, Otten B, Gokeler A, Diercks RL, Lemmink KAPM. Knee Surg Sports Traumatol
Arthrosc. 2017;25(8):2365-2376. doi: 10.1007/s00167-015-3727-0 [doi].
Take Home Message: External focus of attention with a visual feedback may be
optimal for an effective anterior cruciate ligament (ACL) injury prevention
We need to promote
motor learning to optimize the effectiveness of injury prevention programs. Athletes
can learn motor skills with an internal focus of attention (focus on the
movement themselves) or with an external focus of attention (focus on the
movement effect; like touching a target). However, the effect of internal and
external focus feedbacks on kinetics and kinematics during sport-specific tasks,
like sidestep cutting, and their effect on retention of learned motor skills is
unclear. Thus, the authors aimed to examine the effects of a visual external
focus and a verbal internal focus feedback on peak knee loading during
unexpected sidestep cutting over time in female and male athletes. The authors
randomized 90 healthy recreational basketball players into 3 groups with both
sex equally distributed: visual, verbal and control. As participants completed unexpected
sidestep-cutting drills the authors measured numerous kinematic and kinetic
outcomes (e.g., vertical ground reaction force, motion and moments of the
trunk, hip, knee, ankle). All groups performed 3 sessions of sidestep cutting.
During first session, the visual group received visual feedback after each
trial, which was a video of their best performance. The verbal group only received
verbal instructions: (1) ‘bend your trunk forward’, (2) ‘bend your knee’ and
(3) ‘keep your knee straight above your foot’. The control group was only
provided with the general instructions. The participants completed two more sessions
1 week and 4 weeks after the first session. During these sessions they received
no feedback, which allowed the authors to measure a possible retention effect.
Males in the visual group improved and retained better motor skills (e.g., larger
vertical ground reaction forces, knee flexion moment, knee range of motion and
ankle dorsiflexion angle) when compared with the other two groups and females.
The results from this
study support the use of external focus feedback among male athletes. Movement
alterations shown in male athletes who received video feedback can be
interpreted as safer landing strategies. Visual feedback using video analysis
has become popular as an effective tool for injury surveillance and performance
assessment. It would be interesting to know if combining self-feedback methods
and expert modelling with verbal and visual cues will work better for both
sexes. It would also be interesting to see if the learned movement patterns
remain during a practice or game. Clinicians need to consider how to use this
tool effectively in different settings and if it is feasible with a large
team-based training program or better suited for an individual return-to-play
rehabilitation program after an injury.
Questions for Discussion: What type of feedbacks can be effective in clinical
setting? In providing visual feedback, how can one decide on what the best
movement patterns are? How can we examine retention of learned motor skill in
clinical setting?
Written by: Mihyang
Reviewed by: Jeffrey
Related Posts: