Vendrig Tom, Keizer Michèle N J, Brouwer Reinoud W, Houdijk Han
Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Department of Orthopedic Surgery, Martini Hospital, Groningen, the Netherlands.
Orthop J Sports Med. 2025 May 28;13(5):23259671251340996. doi: 10.1177/23259671251340996. eCollection 2025 May.
BACKGROUND: Many sports situations impose high cognitive demands on athletes, requiring them to divide their attention across multiple tasks and leading to landing mechanics associated with an increased anterior cruciate ligament (ACL) load and injury risk. PURPOSE: To investigate the influence of a cognitive dual task on dynamic tibiofemoral movements (ie, dynamic anterior tibial translation [ATTd] and dynamic internal tibial rotation [ITRd]) during jump-landing assessments in healthy participants. STUDY DESIGN: Controlled laboratory study. METHODS: A total of 20 healthy participants performed the side hop for distance, single-leg hop for distance, and triple hop for distance. Each assessment was performed under 2 conditions: once with a dual task (serial subtraction) and once without a dual task, while jumping distance remained consistent across both conditions. ATTd and ITRd were measured using a 3-dimensional motion capture system from 0.25 seconds before initial contact (IC) to 0.75 seconds after IC. Additionally, dynamic knee flexion angle, knee valgus angle, maximal knee flexion moment, and foot angle at IC were measured. RESULTS: While performing a dual task during the side hop for distance, there was less ATTd during the flight phase and more ITRd during the landing phase (maximal difference [MD], 1.65 mm and 2.07°, respectively; < .001), accompanied by a greater foot angle at IC (MD, 2.71°; < .002), resulting in a more pronounced toe landing. During the triple hop for distance, there was more ATTd and less ITRd around IC while performing a dual task (MD, 1.92 mm and 1.42°, respectively; < .001), accompanied by a decreased knee valgus angle (MD, 0.54°; < .001) and a reduced foot angle (MD, 1.75°; < .05), resulting in a flatter heel landing. No effects of the dual task were observed during the single-leg hop for distance. CONCLUSION: Incorporating a cognitive dual task during jump-landing assessments had variable influences on tibiofemoral movements, depending on the assessment. The observed increases in ATTd and ITRd during the landing on certain assessments suggest an increased ACL load and injury risk. CLINICAL RELEVANCE: The incorporation of cognitive dual tasks in ACL injury screening and prevention programs should be considered to potentially reduce the risk of injuries.
背景：许多运动场景对运动员的认知要求很高，要求他们在多项任务之间分配注意力，从而导致落地力学与前交叉韧带（ACL）负荷增加和受伤风险相关。 目的：研究在健康参与者的跳跃落地评估中，认知双重任务对动态胫股关节运动（即动态胫骨前移[ATTd]和动态胫骨内旋[ITRd]）的影响。 研究设计：对照实验室研究。 方法：共有20名健康参与者进行了立定跳远、单腿跳远和三级跳远。每次评估在两种条件下进行：一次伴有双重任务（连续减法），一次不伴有双重任务，且两种条件下的跳跃距离保持一致。使用三维运动捕捉系统从初始接触（IC）前0.25秒至IC后0.75秒测量ATTd和ITRd。此外，还测量了动态屈膝角度、膝外翻角度、最大屈膝力矩以及IC时的足角。 结果：在立定跳远过程中执行双重任务时，飞行阶段的ATTd较小，着陆阶段的ITRd较大（最大差异[MD]分别为1.65毫米和2.07°；P <.001），同时IC时的足角更大（MD为2.71°；P <.002），导致脚尖着地更为明显。在三级跳远过程中，执行双重任务时IC周围的ATTd更大，ITRd更小（MD分别为1.92毫米和1.42°；P <.001），同时膝外翻角度减小（MD为0.54°；P <.001），足角减小（MD为1.75°；P <.05），导致脚跟落地更平。在单腿跳远过程中未观察到双重任务的影响。 结论：在跳跃落地评估中加入认知双重任务对胫股关节运动有不同影响，具体取决于评估方式。在某些评估中着陆时观察到的ATTd和ITRd增加表明ACL负荷和受伤风险增加。 临床意义：在ACL损伤筛查和预防计划中应考虑加入认知双重任务，以潜在降低受伤风险。
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