Pain Catastrophizing Is Associated With Slower Lower-Extremity Visuomotor Reaction Time in Individuals With Anterior Cruciate Ligament Reconstruction During Simulated Sport Distraction.

Abstract

Context: Pain catastrophizing, a psychological response to actual or anticipated pain, has been shown to negatively impact attention and is commonly observed in individuals with anterior cruciate ligament reconstruction (ACLR) and other musculoskeletal conditions. In sport settings, attentional changes associated with pain catastrophizing, combined with environmental distractions, may impair injury-related perceptual-motor skills, such as visuomotor reaction time (VMRT). Characterizing the association between pain catastrophizing and VMRT in an environment that simulates sport-related distractions may highlight the need to address psychological factors that impact attention post-ACLR. The purpose of this study was to examine the association between pain catastrophizing and lower-extremity VMRT among individuals with ACLR under conditions with and without sport-specific visual and auditory stimuli.

Design: Cross-sectional.

Setting: Research laboratory.

Methods: Twenty-three participants (age = 20.4 [3.0] y) postunilateral primary ACLR (time since ACLR = 28.6 [13.0] mo). Participants completed the Pain Catastrophizing Scale (PCS) and a lower-extremity VMRT task in a 360° immersive visualization room under 2 conditions: (1) distraction (sport-specific visual and auditory stimuli playing) and (2) control (no sport-specific visual and auditory stimuli playing). Separate multiple linear regression analyses were conducted to examine the association of PCS scores with ACLR and contralateral limb VMRT (milliseconds) in each condition. Time since ACLR was included as a covariate in each model.

Results: In the distraction condition, PCS scores were significantly associated with ACLR limb VMRT (P = .02, β = 2.71), but not contralateral limb VMRT (P = .14, β = 2.65). In the control condition, PCS scores were not significantly associated with lower-extremity VMRT (ACLR limb VMRT: P = .20, β = 2.31, contralateral limb VMRT: P = .45, β = 1.74).

Conclusion: Individuals with ACLR who exhibited greater pain catastrophizing demonstrated slower ACLR limb VMRT when exposed to a simulated sport-related distraction. Evaluating pain catastrophizing in this population may help rehabilitation specialists identify individuals who could experience lower-extremity VMRT changes in environments with sport-related distractions.