Wohl Timothy R, Criss Cody R, Haggerty Adam L, Rush Justin L, Simon Janet E, Grooms Dustin R
Department of Physical Therapy The Ohio State University.
Honors Tutorial College Ohio University.
Int J Sports Phys Ther. 2024 Nov 1;19(11):1333-1347. doi: 10.26603/001c.123958. eCollection 2024.
Athletes at risk for anterior cruciate ligament (ACL) injury have concurrent deficits in visuocognitive function and sensorimotor brain functional connectivity.
This study aimed to determine whether visual perturbation neuromuscular training (VPNT, using stroboscopic glasses and external visual focus feedback) increases physical and cognitive training demand, improves landing mechanics, and reduces neural activity for knee motor control.
Controlled laboratory study. Methods: Eight right leg dominant healthy female athletes (20.4±1.1yrs; 1.6±0.1m; 64.4±7.0kg) participated in four VPNT sessions. Before and after VPNT, real-time landing mechanics were assessed with the Landing Error Scoring System (LESS) and neural activity was assessed with functional magnetic resonance imaging during a unilateral right knee flexion/extension task. Physical and cognitive demand after each VPNT session was assessed with Borg's Rating of Perceived Exertion (RPE) for both physical and cognitive perceived exertion and the NASA Task Load Index. Descriptives and effect sizes were calculated.
Following VPNT, LESS scores decreased by 1.5 ± 1.69 errors with a large effect size (0.78), indicating improved mechanics, and reductions in BOLD signal were observed in two clusters: 1) left supramarginal gyrus, inferior parietal lobule, secondary somatosensory cortex (p=.012, z=4.5); 2) right superior frontal gyrus, supplementary motor cortex (p<.01, z=5.3). There was a moderate magnitude increase of cognitive RPE between the first and last VPNT sessions.
VPNT provides a clinically feasible means to perturbate visual processing during training that improves athletes' real-time landing mechanics and promotes neural efficiency for lower extremity movement, providing the exploratory groundwork for future randomized controlled trials.
Level 3.
有前交叉韧带（ACL）损伤风险的运动员在视觉认知功能和感觉运动脑功能连接方面同时存在缺陷。
本研究旨在确定视觉干扰神经肌肉训练（VPNT，使用频闪眼镜和外部视觉焦点反馈）是否会增加身体和认知训练需求，改善着陆力学，并减少膝关节运动控制的神经活动。
对照实验室研究。方法：八名右利手健康女性运动员（20.4±1.1岁；身高1.6±0.1米；体重64.4±7.0千克）参加了四次VPNT训练。在VPNT训练前后，使用着陆误差评分系统（LESS）评估实时着陆力学，并在单侧右膝屈伸任务期间使用功能磁共振成像评估神经活动。每次VPNT训练后，使用博格主观用力程度分级量表（RPE）评估身体和认知的主观用力程度以及美国国家航空航天局任务负荷指数，以评估身体和认知需求。计算描述性统计量和效应量。
VPNT训练后，LESS评分降低了1.5±1.69个误差，效应量较大（0.78），表明力学得到改善，并且在两个脑区簇中观察到血氧水平依赖（BOLD）信号降低：1）左侧缘上回、顶下小叶、次级体感皮层（p = 0.012，z = 4.5）；2）右侧额上回、辅助运动皮层（p < 0.01，z = 5.3）。在第一次和最后一次VPNT训练之间，认知RPE有中等程度的增加。
VPNT提供了一种临床上可行的方法，可在训练期间干扰视觉处理，改善运动员的实时着陆力学，并提高下肢运动的神经效率，为未来的随机对照试验提供了探索性基础。
3级。
