Cognitive-Motor Function and Anterior Cruciate Ligament Injury Risk: Exploring Relationships Between Clinical and Lab-Based Assessments.

Abstract

Assessing cognitive-motor function following anterior cruciate ligament reconstruction may enable a more comprehensive assessment of readiness to return to sport. The primary purpose of this study was determining the relationship between measures of clinical cognitive-motor interference and laboratory-based second injury relevant biomechanics through a cross-sectional study.

Methods: Thirty-six individuals following anterior cruciate ligament reconstruction (26 females/10 males, 19.8 [1.8] y; 1.7 [0.1] m; 69.6 [12.8] kg, Tegner activity level 6.8 [1.8], 1.5 [0.6] y post anterior cruciate ligament reconstruction) participated in the study. We assessed 2 clinically feasible tests of cognitive-motor function: single (ST) and dual tasks (DT) for triple hop and medial-side hop. Laboratory-based tests involved motion capture assessment of jump landings from a 30-cm box followed immediately by a secondary jump. Conditions included, ST (anticipated secondary jump direction) and DT (unanticipated secondary jump direction). Primary outcome variables included DT change (DTC) of second anterior cruciate ligament injury predictors (limb asymmetry in knee extensor moment at initial contact, range of knee abduction angle for the involved limb, and uninvolved hip rotation net moment impulse). Correlations were used to identify associations between lab- (biomechanics) and clinic-derived (hop distance) outcomes. Secondary analyses with other risk-associated knee mechanics and patient-reported outcome measures were also performed.

Results: No significant correlations were found between DTC clinical variables and DTC second anterior cruciate ligament predictors. However, significant relationships were observed between clinical and lab outcomes when considering ST or DT in isolation, such as ST range of knee abduction angle for the involved limb correlating with ST for triple hop for both limbs (Inv: r = -.436, Padj = .04; Uninv: r = -.453, Padj = .04).

Conclusions: Associations between cognitive-motor interference (ie, DTC) in clinical and lab tests were not found, but significant fair strength correlations appeared between clinical and lab variables when examining ST and DT performance, separately. Future prospective studies are needed to determine the predictive value of cognitive-motor function for injury rehabilitation decision making.