Effects of cognitive- and motor-dual tasks on postural control regularity following anterior cruciate ligament reconstruction |
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| Institution: | 1. Department of Mechanical and Industrial Engineering, Montana State University, Bozeman, MT, USA;2. Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, USA;3. School of Applied Health Sciences and Wellness, College of Health Sciences & Professions, Ohio University, Athens, OH, USA;4. School of Rehabilitation and Communication Sciences, College of Health Sciences & Professions, Ohio University, Athens, OH, USA;1. University of North Texas Health Science Center, Department of Physical Therapy, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, USA;2. Peterson Regional Medical Center, Ambulatory Care Center, 260 Cully Drive, Kerrville, TX 78028, USA;3. Angelo State University, Physical Therapy Department, ASU Station #10923, San Angelo, Texas 76909, USA;1. Department of Physical Therapy, University of Alabama at Birmingham, 1720 Second Avenue South, AL, USA;2. Department of Kinesiology and Nutrition University of Illinois Chicago;1. Human Motor Systems Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil;2. Laboratory of Integrative Motor Behaviour, Centre for Neuroscience Studies, Queen’s University, Ontario, Canada;3. Exercise Neuroscience Research Group, School of Arts, Sciences, and Humanities, University of São Paulo, São Paulo, Brazil;4. Biomedical Engineering, Federal University of ABC, São Bernardo do Campo, São Paulo, Brazil;1. The SPORT Center, Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, USA;2. Ohio Musculoskeletal & Neurological Institute and Division of Athletic Training, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, USA;3. Pediatric Neuroimaging Research Consortium, Cincinnati Children’s Hospital Medical Center, USA;4. University of Cincinnati College of Medicine, USA;5. Division of Radiology, Cincinnati Children’s Hospital Medical Center, USA;6. Departments of Pediatrics and Orthopaedic Surgery, University of Cincinnati, USA;7. The Micheli Center for Sports Injury Prevention, USA;8. Department of Orthopaedics, University of Pennsylvania, USA;1. College of Health Solutions, Arizona State University, N 5th St., Phoenix, AZ 85282, USA;2. Phoenix VA Health Care Center, 650 E Indian School Rd, Phoenix, AZ, USA |
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| Abstract: | BackgroundHigh injury rates following anterior cruciate ligament reconstruction (ACLR) motivate the need to better understand lingering movement deficiencies following return to sport. Athletic competition involves various types of sensory, motor, and cognitive challenges; however, postural control deficiencies during this spectrum of conditions are not well understood following ACLR.Research questionTo what extent is postural control altered following ACLR in the presence of sensory, motor, and cognitive challenges, and does postural control correlate with patient-reported symptoms?MethodsFourteen individuals following ACLR (4 m/10 f, 21.2 ± 2.4 yr, 76.9 ± 19.1 kg, 1.70 ± 0.14 m) and fourteen matched healthy controls (4 m/10 f, 21.2 ± 1.4 yr, 75.4 ± 15.3 kg, 1.70 ± 0.15 m) participated in the study. Participants completed single-leg balance, ACLR limb or matched side for controls, under four conditions: 1) eyes open, 2) eyes closed, 3) visual-cognitive dual task (i.e., reverse digit span), and 4) motor dual task (i.e., catching a ball). Sample entropy (SEn) was calculated for each balance condition to characterize regularity of center of pressure control. Participants also completed patient-reported outcomes to characterize self-reported knee function, symptoms, and fear. A mixed effects model tested for differences in SEn between balance conditions, and Spearman correlations tested for relationships between SEn and patient-reported outcomes.ResultsA significant Group-by-Condition interaction was detected (P = 0.043). While the motor dual task and eyes closed balance conditions were associated with the lowest SEn for both groups, only the visual-cognitive dual task condition demonstrated a significant difference between groups, with the ACLR group having lower SEn 95% confidence interval for ΔSEn: (0.03, 0.35)]. Lower KOOS-Sport scores were associated with decreased SEn for the ACLR group (ρ = 0.81, P < 0.001).SignificanceThese findings are consistent with ACLR individuals using a less automatic approach to postural control compared to controls, particularly when presented with a visual-cognitive challenge. Altered neuromuscular control persists well after ACLR surgery and can be related to patient-reported outcomes. |
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