CI,[92][93][94][95]. The pivot shift test is very specific, namely 98% (95% CI, 96-99), but has a poor sensitivity of 24% (95% CI, [21][22][23][24][25][26][27]. The anterior drawer test shows good sensitivity and specificity in chronic conditions, respectively 92% (95% CI, 88-95) and 91% (95% CI, 87-94), but not in acute conditions.
Primary anterior cruciate ligament (ACL) injury prevention programs effectively reduce ACL injury risk in the short term. Despite these programs, ACL injury incidence is still high, making it imperative to continue to improve current prevention strategies. A potential limitation of current ACL injury prevention training may be a deficit in the transfer of conscious, optimal movement strategies rehearsed during training sessions to automatic movements required for athletic activities and unanticipated events on the field. Instructional strategies with an internal focus of attention have traditionally been utilized, but may not be optimal for the acquisition of the control of complex motor skills required for sports. Conversely, external-focus instructional strategies may enhance skill acquisition more efficiently and increase the transfer of improved motor skills to sports activities. The current article will present insights gained from the motor-learning domain that may enhance neuromuscular training programs via improved skill development and increased retention and transfer to sports activities, which may reduce ACL injury incidence in the long term.
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