Relationships between Patient-Reported Outcomes and Predictors of Second ACL Injuries during Unanticipated Jump Landings.

Reactive and external visual-cognitive demands are prevalent in sport and likely contribute to ACL injury scenarios. However, these demands are absent in common return-to-sport assessments. This disconnect leaves a blind spot for determining when an athlete can return to sport with mitigated re-injury risk.

Development of a Real-Time Single-Leg Hop Movement Quality Assessment to Identify Lower-Extremity Biomechanical Risk Factors.

Context: The single-leg hop is based solely on performance with no measure of movement quality. The purpose of this study was to (1) develop a real-time screening tool to capture single-leg functional performance and movement quality and (2) to provide preliminary validation (criterion validity) of a trained clinician's real-time movement quality assessment with 3D kinematics.

Study Design: Cross-sectional.

The Neuroplastic Outcomes from Impaired Sensory Expectations (NOISE) hypothesis: How ACL dysfunction impacts sensory perception and knee stability.

Background: The anterior cruciate ligament (ACL) is integral to maintaining knee joint stability but is susceptible to rupture during physical activity. Despite surgical restoration of passive or mechanical stability, patients struggle to regain strength and prior level of function. Recent efforts have focused on understanding how ACL-related changes in the nervous system contribute to deficits in sensorimotor control following injury and reconstruction.

Neurocognitive & Ecological Motor Learning Considerations for the 11+ ACL Injury Prevention Program: A Commentary.

The 11+ is a structured warm-up program designed to prevent injuries in soccer players, but has proven efficacy in many populations, settings and sports. It consists of 15 exercises that target the most common injury sites, such as the knee, ankle, and groin. However, the implementation and adherence of the 11+ remain suboptimal, and recent compelling data indicates underlying mechanisms of injury risk related to neural control of movement may not be adequately targeted.

Individual and combined effects of sport-related concussion and ACL injury on neurocognitive and neuromechanical reaction time.

Context: Recent epidemiological data indicates a potential connection between sport-related concussion (SRC) and elevated anterior cruciate ligament (ACL) injury risk. Limited research exists quantifying cognitive and motor outcome measures between SRC and ACL injury history.

Objective: To examine the individual and combined effects of a history of SRC and ACL injury and reconstruction (ACLR) on neurocognitive and neuromechanical function.

Enhancing Return to Alpine Skiing: Integrating Perceptual-Motor-Cognitive Considerations in Testing and Progressions: A Clinical Commentary.

Unlabelled: Alpine skiing poses significant risks for anterior cruciate ligament (ACL) injury at both recreational and professional levels, which is compounded by high rates of re-injury. Despite the existence of return to sport (RTS) and return to snow protocols, the frequency of ACL re-injury has not been mitigated, raising doubts about protocol effectiveness. Current RTS protocols primarily focus on biomechanical and neuromuscular factors in isolation, neglecting the important perceptual-motor-cognitive changes associated with ACL injuries and the high cognitive demands of skiing.

From Control to Chaos: Visual-Cognitive Progression During Recovery from ACL Reconstruction.

Anterior cruciate ligament tear is a serious knee injury with implications for central nervous system (CNS) plasticity. To perform simple knee movements, people with a history of ACL reconstruction (ACL-R) engage cross-modal brain regions and when challenged with cognitive-motor dual-tasks, physical performance deteriorates. Therefore, people with ACL-R may increase visual-cognitive neural processes for motor control.

Organization of sensorimotor activity in anterior cruciate ligament reconstructed individuals: an fMRI conjunction analysis.

Introduction: Anterior cruciate ligament reconstruction (ACLR) is characterized by persistent involved limb functional deficits that persist for years despite rehabilitation. Previous research provides evidence of both peripheral and central nervous system adaptations following ACLR. However, no study has compared functional organization of the brain for involved limb motor control relative to the uninvolved limb and healthy controls.

The Impact of Differential Knee Laxity on Brain Activation During Passive Knee Joint Loading.

Although higher anterior knee laxity is an established risk factor of ACL injury, underlying mechanisms are uncertain. While decreased proprioception and altered movement patterns in individuals with anterior knee laxity have been identified, the potential impact of higher laxity on brain activity is not well understood. Thus, the purpose of this study is to identify the impact of different magnitudes of knee laxity on brain function during anterior knee joint loading.

Development and Reliability of a Visual-Cognitive Reactive Triple Hop Test.

Context: Current lower-extremity return to sport testing primarily considers the physical status of an athlete; however, sport participation requires continuous cognitive dual-task engagement. Therefore, the purpose was to develop and evaluate the reliability of a visual-cognitive reactive (VCR) triple hop test that simulates the typical sport demand of combined online visual-cognitive processing and neuromuscular control to improve return to sport testing after lower-extremity injury.

Design: Test-retest reliability.

Combining Neurocognitive and Functional Tests to Improve Return-to-Sport Decisions Following ACL Reconstruction.

Neuroplasticity after anterior cruciate ligament (ACL) injury alters how the nervous system generates movement and maintains dynamic joint stability. The postinjury neuroplasticity can cause neural compensations that increase reliance on neurocognition. Return-to-sport testing quantifies physical function but fails to detect important neural compensations.

The effects of sports-related concussion history on female adolescent brain activity and connectivity for bilateral lower extremity knee motor control.

Sports-related concussions (SRCs) are associated with neuromuscular control deficits in athletes following return to play. However, the connection between SRC and potentially disrupted neural regulation of lower extremity motor control has not been investigated. The purpose of this study was to investigate brain activity and connectivity during a functional magnetic resonance imaging (fMRI) lower extremity motor control task (bilateral leg press) in female adolescent athletes with a history of SRC.

A Preliminary Investigation into the Neural Correlates of Knee Loading during a Change of Direction Task in Individuals after Anterior Cruciate Ligament Reconstruction.

Background: Central nervous system (CNS) function after ACLR, quantified by the blood oxygen level dependent (BOLD) response, is altered in regions of sensory function during knee movement after ACLR. However, it is unknown how this altered neural response may manifest in knee loading and response to sensory perturbations during sport specific movements.

Purpose: To investigate the relationship among CNS function and lower extremity kinetics, under multiple visual conditions, during 180° change of direction task in individuals with a history of ACLR.

Cognitive Load Influences Drop Jump Landing Mechanics During Cognitive-Motor-Simulated Shooting.

Introduction: Military duties require immense cognitive-motor multitasks that may predispose soldiers to musculoskeletal injury. Most cognitive challenges performed in the research laboratory are not tactical athlete specific, limiting generalizability and transferability to in-field scenarios. The purpose of this study was to determine the impact of a cognitive-motor multitask (forward drop jump landing while simultaneously performing simulated shooting) on knee kinetics and kinematics.

The relationship between drop vertical jump action-observation brain activity and kinesiophobia after anterior cruciate ligament reconstruction: A cross-sectional fMRI study.

Background: Injury and reconstruction of anterior cruciate ligament (ACL) result in central nervous system alteration to control the muscles around the knee joint. Most individuals with ACL reconstruction (ACLR) experience kinesiophobia which can prevent them from returning to activity and is associated with negative outcomes after ACLR. However, it is unknown if kinesiophobia alters brain activity after ACL injury.

Sex-Specific Brain Activations during Single-Leg Exercise.

Background: Females have an increased incidence of musculoskeletal injuries compared to males. Sex differences in neuromuscular control has been widely studied regarding the dynamics and muscle activity during preplanned movements. While muscle activation patterns and movement biomechanics are understood to differ between sexes, it is not well understood how sex influences brain activity for lower extremity movement.

Lower extremity Interlimb coordination associated brain activity in young female athletes: A biomechanically instrumented neuroimaging study.

Bilateral sensorimotor coordination is required for everyday activities, such as walking and sitting down/standing up from a chair. Sensorimotor coordination functional neuroimaging (fMRI) paradigms (e.g.

Preliminary brain-behavioral neural correlates of anterior cruciate ligament injury risk landing biomechanics using a novel bilateral leg press neuroimaging paradigm.

Anterior cruciate ligament (ACL) injury risk reduction strategies primarily focus on biomechanical factors related to frontal plane knee motion and loading. Although central nervous system processing has emerged as a contributor to injury risk, brain activity associated with the resultant ACL injury-risk biomechanics is limited. Thus, the purposes of this preliminary study were to determine the relationship between bilateral motor control brain activity and injury risk biomechanics and isolate differences in brain activity for those who demonstrate high versus low ACL injury risk.

Development and reliability of a visual-cognitive medial side hop for return to sport testing.

Objectives: To develop and evaluate the reliability of a new visual-cognitive medial side hop (VCMH) test that challenges physical and cognitive performance to potentially improve return to sport testing.

Design: Test-retest experimental design.

Setting: Laboratory.

Effects of cognitive- and motor-dual tasks on postural control regularity following anterior cruciate ligament reconstruction.

Background: High 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 Question: To 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?

Methods: Fourteen individuals following ACLR (4 m/10 f, 21.