Alterations in physical and neurocognitive wellness across recovery after ACLR: A preliminary look into learned helplessness.

OBJECTIVES

Neural alterations after anterior cruciate ligament reconstruction (ACLR) may initiate a maladaptive neurocognitive response (learned helplessness [LH]). Understanding the interrelationships between neural inhibition, quadriceps function and psychological responses can provide clinicians areas to target during recovery. The purpose was to longitudinally evaluate neural excitability, strength and self-reported LH after ACL injury and to explore the relationship between these measures and knee mechanics and patient reported function.

DESIGN

Case-series.

SETTING

University.

PARTICIPANTS

Eight patients were evaluated across recovery after ACL injury.

MAIN OUTCOME MEASURES

Neural activity, quadriceps function, and self-reported LH were evaluated at pre-surgery, 3-months post-ACLR and at the time of return to play (RTP).

RESULTS

Patients presented with higher helplessness between 3-months and RTP. Neural excitability and quadriceps function were variable and associated with various aspects of LH. These findings indicate a systemic inability to generate appropriate neural signaling to the quadriceps and highlights how these changes may influence perceived helplessness and overall function after ACLR.

CONCLUSIONS

LH is related to both measures of physical function and neural outcomes and varies across recovery. This may provide clinicians with a feasible clinical tool that has the potential to identify a variety of impairments arising after ACLR.