Avedesian Jason M, Covassin Tracey, Baez Shelby, Nash Jennifer, Nagelhout Ed, Dufek Janet S
Emory Sports Performance and Research Center, Flowery Branch, Georgia, USA.
Department of Kinesiology and Nutrition Sciences, University of Nevada-Las Vegas, Las Vegas, Nevada, USA.
Orthop J Sports Med. 2021 Aug 24;9(8):23259671211032246. doi: 10.1177/23259671211032246. eCollection 2021 Aug.
Collegiate athletes with prior sports-related concussion (SRC) are at increased risk for lower extremity (LE) injuries; however, the biomechanical and cognitive mechanisms underlying the SRC-LE injury relationship are not well understood.
To examine the association between cognitive performance and LE land-and-cut biomechanics among collegiate athletes with and without a history of SRC and to determine the association among multiple cognitive testing batteries in the same athlete cohort.
Controlled laboratory study.
A cohort of 20 collegiate athletes with prior SRC (9 men, 11 women; mean ± standard deviation [SD] age, 20.5 ± 1.3 years; mean ± SD time since last SRC, 461 ± 263 days) and 20 matched controls (9 men, 11 women; mean ± SD age, 19.8 ± 1.3 years) completed land-and-cut tasks using the dominant and nondominant limbs. LE biomechanical variables and a functional visuomotor reaction time (FVMRT) were collected during each trial. Athletes also completed the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) and Senaptec Sensory Station assessments.
In the SRC cohort, Pearson correlation coefficients indicated slower FVMRT was moderately correlated with decreased dominant limb ( = -0.512) and nondominant limb ( = -0.500) knee flexion, while increased dominant limb knee abduction moment was moderately correlated with decreased ImPACT Visual Memory score ( = -0.539) and slower ImPACT Reaction Time ( = 0.515). Most computerized cognitive measures were not associated with FVMRT in either cohort ( > .05).
Decreased reaction time and working memory performance were moderately correlated with decreased sagittal plane knee motion and increased frontal plane knee loading in collegiate athletes with a history of SRC. The present findings suggest a potential unique relationship between cognitive performance and LE neuromuscular control in athletes with a history of SRC injury. Last, we determined that computerized measures of cognitive performance often utilized for SRC management are dissimilar to sport-specific cognitive processes.
Understanding the relationship between cognitive performance and LE biomechanics in athletes with prior SRC may inform future clinical management strategies. Future research should prospectively assess cognitive and biomechanical measures, along with LE injury incidence, to identify mechanisms underlying the SRC-LE injury relationship.
既往有运动相关脑震荡（SRC）的大学生运动员下肢（LE）受伤风险增加；然而，SRC与LE损伤关系背后的生物力学和认知机制尚未完全明确。
研究有和无SRC病史的大学生运动员认知表现与LE落地和切入生物力学之间的关联，并确定同一运动员队列中多种认知测试组合之间的关联。
对照实验室研究。
20名既往有SRC的大学生运动员（9名男性，11名女性；平均±标准差[SD]年龄，20.5±1.3岁；距上次SRC的平均±SD时间，461±263天）和20名匹配的对照组（9名男性，11名女性；平均±SD年龄，19.8±1.3岁）使用优势和非优势肢体完成落地和切入任务。在每次试验期间收集LE生物力学变量和功能性视觉运动反应时间（FVMRT）。运动员还完成了脑震荡后即刻评估和认知测试（ImPACT）以及Senaptec感觉站评估。
在SRC队列中，Pearson相关系数表明，较慢的FVMRT与优势肢体（=-0.512）和非优势肢体（=-0.500）膝关节屈曲减少中度相关，而优势肢体膝关节外展力矩增加与ImPACT视觉记忆评分降低（=-0.539）和ImPACT反应时间减慢（=0.515）中度相关。在两个队列中，大多数计算机化认知测量与FVMRT均无关联（>.05）。
在有SRC病史的大学生运动员中，反应时间和工作记忆表现的降低与矢状面膝关节运动减少和额状面膝关节负荷增加中度相关。目前的研究结果表明，有SRC损伤病史的运动员认知表现与LE神经肌肉控制之间存在潜在的独特关系。最后，我们确定常用于SRC管理的计算机化认知表现测量与特定运动的认知过程不同。
了解既往有SRC的运动员认知表现与LE生物力学之间的关系可能为未来的临床管理策略提供信息。未来的研究应前瞻性地评估认知和生物力学测量以及LE损伤发生率，以确定SRC与LE损伤关系背后的机制。
