Research Information System
Physical Therapy in Sport, vol.79, 2026 (SCI-Expanded, Scopus)
AbstractObjectiveTo examine the acute effects of different attentional focus instructions (External Focus-EF, Internal Focus-IF, Neutral Focus-NF) on isokinetic strength, hop distances, and dynamic balance performance during clinical return-to-sport (RTS) assessments post- ACLR.Design/setting/patientsCross-sectional study in a research laboratory. 35 participants (10F/25M, 24,3 ± 7,77 years) who underwent primary unilateral ACLR with hamstring grafts (35.1 ± 9.2 weeks post-surgery) were included.Main outcome measuresParticipants performed isokinetic knee extension/flexion, Y-Balance Test (YBT), single/triple/crossover hops, and vertical jumps under randomized EF, IF, and NF conditions. Data were analysed using repeated measures ANOVA with Cohen's d effect sizes.ResultsCompared to IF, EF increased injured-side quadriceps force production at 60°/s (p < 0.05). On the uninjured side, EF significantly increased both hamstring and quadriceps force production at all speeds (p < 0.01; d = 0.30–0.37). In YBT, EF yielded higher posteromedial/posterolateral distances and composite scores versus IF and NF (p < 0.05; d = 0.42–0.63). EF produced greater distances in all single-leg hops on both sides versus IF (p < 0.05; d = 0.19-0.39). No significant differences occurred in vertical jumps.ConclusionAttentional focus significantly influences performance post-ACLR. Using EF minimizes the inhibitory effects of IF, providing a more accurate representation of true functional limits. Clinicians should standardize EF guidelines to improve RTS decision-making based on maximum achievable performance.