Clinical trial NCT06746454: The Gender-Specific Effect of Different Instruction Training
Official title: Gender-Specific Effects of Different Focus of Attention Instructions on Landing Technique, Alignment, and Joint Position Sense in Semi-Professional Volleyball Players
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Sports Injury
Keywords: motor learning
proprioception
volleyball
knee valgus
drop vertical jump test
Lead sponsor: Bahçeşehir University
Sponsor class: OTHER
First posted: 2024-12-24
Enrollment: 48
Sex: ALL
Minimum age (years): 18
Maximum age (years): 24
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Randomized, single-blind, prospective study
Primary purpose: PREVENTION

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.

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

Primary outcomes:
measure: Landing Error Scoring System (LESS) Measurement
timeFrame: baseline, immediately after the intervention, one week after the baseline
Secondary outcomes:
measure: Frontal Plan Projection Angle (FPPA) Measurement
timeFrame: baseline, immediately after the intervention, one week after the baseline
measure: Knee Joint Position Sense (KJPS) Measurement
timeFrame: baseline, immediately after the intervention, one week after the baseline
Other outcomes:
Locations:
city: İzmir
country: Turkey
facility: Smyrna Sports Club
Study officials:
affiliation: Bahcesehir University, Graduate Education Institute, Physiotherapy and Rehabilitation, Master of Science Program
name: Oktay Şenozan, PT
role: PRINCIPAL_INVESTIGATOR
affiliation: Bahcesehir University, Faculty of Health Sciences
name: Pelin Pişirici, PT, PhD
role: STUDY_DIRECTOR
References: