Herman Daniel C, Barth Jeffrey T
Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida, USA
Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia, USA.
Am J Sports Med. 2016 Sep;44(9):2347-53. doi: 10.1177/0363546516657338. Epub 2016 Jul 29.
Neurocognitive status may be a risk factor for anterior cruciate ligament (ACL) injury. Neurocognitive domains such as visual attention, processing speed/reaction time, and dual-tasking may influence ACL injury risk via alterations to neuromuscular performance during athletic tasks. However, the relationship between neurocognition and performance during athletic tasks is not yet established.
Athletes with low baseline neurocognitive scores will demonstrate poorer jump landing performance compared with athletes with high baseline neurocognitive score.
Controlled laboratory study.
Neurocognitive performance was measured using the Concussion Resolution Index (CRI). Three-dimensional kinematic and kinetic data of the dominant limb were collected for 37 recreational athletes while performing an unanticipated jump-landing task. Healthy, nonconcussed subjects were screened using a computer-based neurocognitive test into a high performers (HP; n = 20; average CRI percentile, 78th) and a low performers (LP; n = 17; average CRI percentile, 41st) group. The task consisted of a forward jump onto a force plate with an immediate rebound to a second target that was assigned 250 milliseconds before landing on the force plate. Kinematic and kinetic data were obtained during the first jump landing.
The LP group demonstrated significantly altered neuromuscular performance during the landing phase while completing the jump-landing task, including significantly increased peak vertical ground-reaction force (mean ± SD of LP vs HP: 1.81 ± 0.53 vs 1.38 ± 0.37 body weight [BW]; P < .01), peak anterior tibial shear force (0.91 ± 0.17 vs 0.72 ± 0.22 BW; P < .01), knee abduction moment (0.47 ± 0.56 vs 0.03 ± 0.64 BW × body height; P = .03), and knee abduction angle (6.1° ± 4.7° vs 1.3° ± 5.6°; P = .03), as well as decreased trunk flexion angle (9.6° ± 9.6° vs 16.4° ± 11.2°; P < .01).
Healthy athletes with lower baseline neurocognitive performance generate knee kinematic and kinetic patterns that are linked to ACL injury.
Neurocognitive testing using the CRI may be useful for identification of athletes at elevated risk for future ACL injury.
神经认知状态可能是前交叉韧带（ACL）损伤的一个风险因素。视觉注意力、处理速度/反应时间以及多任务处理等神经认知领域可能会通过改变运动任务期间的神经肌肉表现来影响ACL损伤风险。然而，神经认知与运动任务表现之间的关系尚未确立。
与基线神经认知得分高的运动员相比，基线神经认知得分低的运动员在跳跃着陆表现上会更差。
对照实验室研究。
使用脑震荡恢复指数（CRI）测量神经认知表现。在37名休闲运动员执行意外的跳跃着陆任务时，收集其优势肢体的三维运动学和动力学数据。通过基于计算机的神经认知测试，将健康、未受过脑震荡的受试者筛选为高表现者（HP；n = 20；平均CRI百分位数，第78位）和低表现者（LP；n = 17；平均CRI百分位数，第41位）两组。任务包括向前跳到测力板上，然后立即反弹到第二个目标，该目标在落在测力板之前250毫秒确定。在第一次跳跃着陆期间获取运动学和动力学数据。
LP组在完成跳跃着陆任务的着陆阶段表现出明显改变的神经肌肉表现，包括显著增加的垂直地面反作用力峰值（LP与HP的平均值±标准差：1.81±0.53与1.38±0.37体重[BW]；P <.01）、胫骨前剪切力峰值（0.91±0.17与0.72±0.22 BW；P <.01）、膝关节外展力矩（0.47±0.56与0.03±0.64 BW×身高；P =.第3页共3页03）和膝关节外展角度（6.1°±4.7°与1.3°±5.6°；P =.03），以及减小的躯干屈曲角度（9.6°±9.6°与16.4°±11.2°；P <.01）。
基线神经认知表现较低的健康运动员会产生与ACL损伤相关的膝关节运动学和动力学模式。
使用CRI进行神经认知测试可能有助于识别未来ACL损伤风险较高的运动员。
