Chaput Meredith, Onate James A, Simon Janet E, Criss Cody R, Jamison Steve, McNally Michael, Grooms Dustin R
Division of Physical Therapy, School of Rehabilitation & Communication Sciences, College of Health Sciences and Professions, Ohio University, Athens, Ohio, USA.
Ohio Musculoskeletal & Neurological Institute, Ohio University, Athens, Ohio, USA.
J Orthop Res. 2022 Jan;40(1):95-104. doi: 10.1002/jor.25014. Epub 2021 Mar 8.
Visual cognitive ability has previously been associated with anterior cruciate ligament injury and injury risk biomechanics in healthy athletes. Neuroimaging reports have identified increased neural activity in regions corresponding to visual-spatial processing, sensory integration, and visual cognition in individuals after anterior cruciate ligament reconstruction (ACLR), indicating potential neural compensatory strategies for motor control. However, it remains unclear whether there is a relationship between visual cognition, neural activity, and metrics of neuromuscular ability after ACLR. The purpose of this study was to (1) evaluate the relationship between visual cognitive function and measurements of neuromuscular control (proprioception and time to stability [TTS]), isokinetic strength, and subjective function, and (2) examine the neural correlates of visual cognition between ACLR (n = 16; time since surgery 41.4 ± 33.0 months) and demographically similar controls (n = 15). Visual cognition was assessed by the ImPACT visual motor and visual memory subscales. Outcome variables of proprioception to target knee angle 20°, landing TTS, strength, and subjective function were compared between groups, and visual cognition was correlated within groups to determine the relationship between visual cognition and outcome variables controlled for time from surgery (ACLR group). The control group had better IKDC scores and strength. Visual memory and visual motor ability were negatively associated with proprioception error (r = -0.63) and TTS (r = -0.61), respectively, in the ACLR group but not controls. Visual cognition was associated with increased neural activity in the precuneus and posterior cingulate cortex in the ACLR group but not control participants. These data suggest the neural strategy in which ACLR participants maintain proprioception and stability varies, and may depend on visual cognition and sensory integration neural activity.
视觉认知能力此前已与健康运动员的前交叉韧带损伤及损伤风险生物力学相关联。神经影像学报告显示，在前交叉韧带重建（ACLR）术后个体中，与视觉空间处理、感觉整合及视觉认知相对应的区域神经活动增强，这表明存在潜在的运动控制神经代偿策略。然而，ACLR术后视觉认知、神经活动与神经肌肉能力指标之间是否存在关联仍不明确。本研究的目的是：（1）评估视觉认知功能与神经肌肉控制测量指标（本体感觉和达到稳定的时间 [TTS]）、等速肌力及主观功能之间的关系；（2）检查ACLR组（n = 16；术后时间41.4 ± 33.0个月）与人口统计学特征相似的对照组（n = 15）之间视觉认知的神经关联。通过ImPACT视觉运动和视觉记忆子量表评估视觉认知。比较两组之间目标膝关节角度20°时的本体感觉、落地TTS、力量及主观功能等结果变量，并在组内将视觉认知进行关联，以确定视觉认知与控制手术时间后的结果变量（ACLR组）之间的关系。对照组的IKDC评分和力量更好。在ACLR组而非对照组中，视觉记忆和视觉运动能力分别与本体感觉误差（r = -0.63）和TTS（r = -0.61）呈负相关。在ACLR组而非对照参与者中，视觉认知与楔前叶和后扣带回皮质神经活动增加相关。这些数据表明，ACLR参与者维持本体感觉和稳定性的神经策略各不相同，可能取决于视觉认知和感觉整合神经活动。
