The effects of attentional focus on jump performance and knee joint kinematics in patients after ACL reconstruction

• External focus instructions foster safe landing patterns.
• External focus instruction yields greater peak knee flexion for both legs after ACLR.
• Clinicians should use quantitative and qualitative analyses of hop tests.

ObjectivesThe purpose of this study was to determine the effect of an internal and external attentional focus on single leg hop jump distance and knee kinematics in patients after ACL reconstruction (ACLR).DesignExperimental.SettingOutpatient physical therapy facility.ParticipantsSixteen patients after ACLR.Main Outcome MeasuresPatients received either an instruction with an internal focus or an external focus before performing a single leg hop jump. The jump distance, knee valgus angle at initial contact, peak knee valgus angle, knee flexion angle at initial contact, peak knee flexion angle, total ROM and time to peak angles for the injured and non-injured legs were recorded. A repeated measures MANOVA was used to determine significance between the experimental conditions with the primary outcome measures as dependent variables.ResultsThe external focus group had significant larger knee flexion angles at initial contact, peak knee flexion, total ROM and time to peak knee flexion for the injured legs.ConclusionsThis study demonstrates the applicability of using an external focus during rehabilitation of patients after ACLR to enhance safer movement patterns compared to an internal focus of attention and subsequently may help to reduce second ACL injury risk.