Comparing the Immediate Effects of Holistic and External Focus of Attention on Single-Leg Jump Distance and Knee Flexion Range of Motion of Female Athletes Prone to Anterior Cruciate Ligament Injury

 One of the most common sports injuries is the anterior cruciate ligament (ACL) injury. So far, research has supported the positive effect of training instructions based on an external focus of attention, but no study has been conducted on the effect of a holistic focus of attention in ACL injury prevention. This study aims to compare the effects of holistic and external focus of attention on single-leg jump length and knee flexion range of motion (ROM) of female athletes at risk of ACL injury.

This is a quasi-experimental study. Thirteen female athletes prone to ACL injury (diagnosed the by Tuck jump test) with a mean age of 23.77±4.42 years were selected purposefully. They performed three jumps under each instruction condition (control, external focus, and holistic focus) and nine jumps in total. The single-leg hop test was used to assess the jumping performance of the participants. The effect of the order of conditions was controlled by counterbalancing. Thus, after three jumps in the control condition, group 1 first performed three jumps under the holistic-focus condition and then three jumps under the external-focus condition, while group 2 performed the jumps in the reversed order. Data analysis was performed using repeated measures ANOVA, followed by pairwise comparisons using the Bonferroni test. P<0.05 was considered statistically significant.

 According to the results of ANOVA, the effect of the focus of attention on the jump distance and knee flexion ROM was significant (P=0.001, P<0.0001, respectively). The pairwise comparisons showed that the jump distance and knee flexion ROM under the external-focus condition were significantly higher than under the control condition (P=0.002), but there was no significant difference between the external- and holistic-focus conditions in the jump distance (P=0.622) and knee flexion ROM (P=0.965). The difference in the jump distance between holistic-focus and control conditions was not significant (P=0.078), but the knee flexion ROM was significantly higher under the holistic-focus condition than under the control attention (P=0.001).

 It seems that the instructions using the external or holistic focus of attention can increase knee flexion ROM, and the external-focus instructions can increase the single-leg jump performance in female athletes prone to ACL injuries.