Sherman David A, Baumeister Jochen, Stock Matt S, Murray Amanda M, Bazett-Jones David M, Norte Grant E
Live4 Physical Therapy and Wellness, Acton, MA, USA; Dept. of Physical Therapy & Athletic Training, College of Health & Rehabilitation Science: Sargent College, Boston University, Boston, MA, USA; Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA.
Exercise Science & Neuroscience Unit, Department of Exercise & Health, Faculty of Science, Paderborn University, Paderborn, Germany.
Clin Neurophysiol. 2023 May;149:88-99. doi: 10.1016/j.clinph.2023.02.175. Epub 2023 Mar 9.
To compare brain activity between individuals with anterior cruciate ligament reconstruction (ACLR) and controls during balance. To determine the influence of neuromodulatory interventions (external focus of attention [EF] and transcutaneous electrical nerve stimulation [TENS]) on cortical activity and balance performance.
Individuals with ACLR (n = 20) and controls (n = 20) performed a single-limb balance task under four conditions: internal focus (IF), object-based-EF, target-based-EF, and TENS. Electroencephalographic signals were decomposed, localized, and clustered to generate power spectral density in theta and alpha-2 frequency bands.
Participants with ACLR had higher motor-planning (d = 0.5), lower sensory (d = 0.6), and lower motor activity (d = 0.4-0.8), while exhibiting faster sway velocity (d = 0.4) than controls across all conditions. Target-based-EF decreased motor-planning (d = 0.1-0.4) and increased visual (d = 0.2), bilateral sensory (d = 0.3-0.4), and bilateral motor (d = 0.4-0.5) activity in both groups compared to all other conditions. Neither EF conditions nor TENS changed balance performance.
Individuals with ACLR exhibit lower sensory and motor processing, higher motor planning demands, and greater motor inhibition compared to controls, suggesting visual-dependence and less automatic balance control. Target-based-EF resulted in favorable reductions in motor-planning and increases in somatosensory and motor activity, transient effects in line with impairments after ACLR.
Sensorimotor neuroplasticity underlies balance deficits in individuals with ACLR. Neuromodulatory interventions such as focus of attention may induce favorable neuroplasticity along with performance benefits.
比较前交叉韧带重建（ACLR）患者与对照组在平衡过程中的大脑活动。确定神经调节干预措施（外部注意力焦点[EF]和经皮电刺激神经[TENS]）对皮质活动和平衡表现的影响。
ACLR患者（n = 20）和对照组（n = 20）在四种条件下进行单腿平衡任务：内部注意力焦点（IF）、基于物体的EF、基于目标的EF和TENS。对脑电图信号进行分解、定位和聚类，以生成θ和α-2频段的功率谱密度。
在所有条件下，ACLR患者的运动计划能力较高（d = 0.5），感觉能力较低（d = 0.6），运动活动较低（d = 0.4 - 0.8），同时摆动速度比对照组快（d = 0.4）。与所有其他条件相比，基于目标的EF在两组中均降低了运动计划能力（d = 0.1 - 0.4），并增加了视觉（d = 0.2）、双侧感觉（d = 0.3 - 0.4）和双侧运动（d = 0.4 - 0.5）活动。EF条件和TENS均未改变平衡表现。
与对照组相比，ACLR患者表现出较低的感觉和运动处理能力、较高的运动计划需求以及更强的运动抑制，表明其依赖视觉且自动平衡控制能力较差。基于目标的EF导致运动计划能力得到有利降低，躯体感觉和运动活动增加，这些短暂效应与ACLR后的损伤情况相符。
感觉运动神经可塑性是ACLR患者平衡缺陷的基础。注意力焦点等神经调节干预措施可能会诱导有利的神经可塑性并带来表现改善。
