Ness Brandon M, Zimney Kory, Schweinle William E, Cleland Joshua A
Department of Physical Therapy, University of South Dakota, Vermillion, SD, United States.
Department of Physician Assistant Studies, University of South Dakota, Vermillion, SD, United States.
Int J Sports Phys Ther. 2020 Dec;15(6):840-855. doi: 10.26603/ijspt20200840.
Several systematic reviews have evaluated the role of dual-task assessment in individuals with concussion. However, no systematic reviews to date have investigated dual-task protocols with implications for individuals with anterior cruciate ligament (ACL) injury or ACL reconstruction (ACLR).
To systematically review the evidence on dual-task assessment practices applicable to those with ACL deficiency/ACLR, specifically with the aim to identify motor-cognitive performance costs.
Systematic review.
A systematic literature review was undertaken on those with ACL-deficient or ACL-reconstructed knees performing dual-task activities. The following databases were searched from inception to June 8, 2018 including CINAHL, PsychInfo, PubMed, SPORTDiscus, Web of Science, and gray literature. Three primary search categories (knee, cognition, and motor task) were included. Only one reviewer independently performed the database search, data extraction, and scored each article for quality. All studies were assessed for quality and pertinent data were extracted, examined and synthesized.
Ten studies were included for analysis, all of which were published within the prior ten years. Performance deficits were identified in those with either ACL deficiency or ACLR while dual-tasking, such as prioritization of postural control at the expense of cognitive performance, impaired postural control in single limb stance, greater number of cognitive errors, and increased step width coefficient of variation while walking. No studies examined those with prior ACL injury or ACLR during tasks that mimicked ACL injury mechanisms such as jump-landing or single-leg cutting.
The results of the current systematic review suggests that postural control, gait, and/or cognitive deficits exist when evaluated under a dual-task paradigm in those with ACL deficiency or ACLR. This systematic review highlights the need for future research on dual-task assessment for individuals who have sustained an ACL injury or undergone ACLR, specifically utilizing more difficult athletic movements.
Level 3a.
多项系统评价评估了双重任务评估在脑震荡患者中的作用。然而，迄今为止，尚无系统评价对适用于前交叉韧带（ACL）损伤或ACL重建（ACLR）患者的双重任务方案进行研究。
系统评价适用于ACL缺陷/ACLR患者的双重任务评估证据，具体目的是确定运动认知表现成本。
系统评价。
对患有ACL缺陷或ACL重建膝关节的患者进行双重任务活动的情况进行系统文献综述。检索了从数据库建立至2018年6月8日的以下数据库，包括护理学与健康领域数据库（CINAHL）、心理学文摘数据库（PsychInfo）、医学期刊数据库（PubMed）、体育科学数据库（SPORTDiscus）、科学引文索引数据库（Web of Science）和灰色文献。纳入了三个主要搜索类别（膝盖、认知和运动任务）。仅由一名评审员独立进行数据库搜索、数据提取，并对每篇文章的质量进行评分。对所有研究进行质量评估，并提取、检查和综合相关数据。
纳入10项研究进行分析，所有研究均在过去十年内发表。在进行双重任务时，ACL缺陷或ACLR患者存在表现缺陷，例如以牺牲认知表现为代价优先进行姿势控制、单腿站立时姿势控制受损、认知错误数量增加以及行走时步幅变异系数增加。没有研究在模拟ACL损伤机制（如跳跃着陆或单腿切入）的任务中检查既往有ACL损伤或ACLR的患者。
当前系统评价的结果表明，在双重任务范式下评估时，ACL缺陷或ACLR患者存在姿势控制、步态和/或认知缺陷。本系统评价强调了未来对ACL损伤或接受ACLR的个体进行双重任务评估研究的必要性，特别是采用更具难度的运动动作。
3a级。
