Slower visuomotor reaction time in division-I collegiate athletes with a history of ankle sprain

Background: The rate of return to sport after surgical treatment of femoroacetabular impingement (FAI) syndrome (FAIS) has been studied in high-level athletes. However, few studies examining this rate have focused exclusively on National Collegiate Athletic Association (NCAA) Division I athletes. Purpose: To evaluate the return-to-sport rate after hip arthroscopy for FAIS and to examine the influence of sport type on the clinical presentation of FAIS in collegiate athletes. Study Design: Case series; Level of evidence, 4. Methods: Included in this study were NCAA Division I student-athletes who underwent hip arthroscopy for FAIS at our institution between 2010 and 2017. Exclusion criteria were history of previous hip pathology, pediatric hip disease, radiographic evidence of osteoarthritis (Tönnis grade >0), prior lower extremity procedure, history of chronic pain, osteoporosis, or history of systemic inflammatory disease. Athletes were categorized into 6 subgroups based on the type of sport (cutting, contact, endurance, impingement, asymmetric/overhead, and flexibility) by using a previously reported classification system. Patient characteristics and preoperative, intraoperative, and return-to-sport variables were compared among sport types. Results: A total of 49 hip arthroscopies for FAIS were performed in 39 collegiate athletes (10 females, 29 males; mean age, 19.5 ± 1.3 years). A total of 1 (2.6%) cutting athlete, 15 (38.5%) contact athletes, 8 (20.5%) impingement athletes, 6 (15.4%) asymmetric/overhead athletes, and 9 (23.1%) endurance athletes were included in the study. There were no differences among sports groups with respect to the FAI type. Endurance athletes had lower rates of femoral osteochondroplasty (45.5%) and labral debridement (0.0%) ( P < .0001). Contact sport athletes had higher rates of labral debridement (50.0%; P < .0001). Patients were evaluated for return to sport at an average of 1.96 ± 0.94 years. Overall, the return-to-sport rate was 89.7%. There were no differences in return-to-sport rates based on the sport type except for endurance athletes, who returned at a lower rate (66.6%; P < .001). No differences in return-to-sport rate ( P = .411), duration after return ( P = .265), or highest attempted level of sport resumed ( P = .625) were found between patients who underwent labral repair versus debridement. Conclusion: Collegiate-level athletes who underwent hip arthroscopy for FAIS returned to sport at high and predictable rates, with endurance athletes possibly returning to sport at lower rates than all other sport types. Surgical procedures may be influenced by sport type, but the rate of return to sport between athletes who underwent labral debridement versus labral repair was similar.

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Relationship Between Cognitive Performance and Lower Extremity Biomechanics: Implications for Sports-Related Concussion

Orthopaedic Journal of Sports Medicine ◽

10.1177/23259671211032246 ◽

2021 ◽

Vol 9 (8) ◽

pp. 232596712110322

Author(s):

Jason M. Avedesian ◽

Tracey Covassin ◽

Shelby Baez ◽

Jennifer Nash ◽

Ed Nagelhout ◽

...

Keyword(s):

Reaction Time ◽

Lower Extremity ◽

Cognitive Performance ◽

Pearson Correlation ◽

Collegiate Athletes ◽

Neuromuscular Control ◽

Cognitive Test ◽

Injury Incidence ◽

Increased Risk ◽

History Of

Background: 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. Purpose: 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. Study Design: Controlled laboratory study. Methods: 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. Results: In the SRC cohort, Pearson correlation coefficients indicated slower FVMRT was moderately correlated with decreased dominant limb ( r = –0.512) and nondominant limb ( r = –0.500) knee flexion, while increased dominant limb knee abduction moment was moderately correlated with decreased ImPACT Visual Memory score ( r = –0.539) and slower ImPACT Reaction Time ( r = 0.515). Most computerized cognitive measures were not associated with FVMRT in either cohort ( P > .05). Conclusion: 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. Clinical Relevance: 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.

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The Effect of Ankle Disk Training on Muscle Reaction Time in Subjects with a History of Ankle Sprain

The American Journal of Sports Medicine ◽

10.1177/03635465010290051601 ◽

2001 ◽

Vol 29 (5) ◽

pp. 627-632 ◽

Cited By ~ 81

Author(s):

Michael D. Osborne ◽

Li-Shan Chou ◽

Edward R. Laskowski ◽

Jay Smith ◽

Kenton R. Kaufman

Keyword(s):

Reaction Time ◽

Ankle Sprain ◽

History Of

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Concussion History and Postconcussion Neurocognitive Performance and Symptoms in Collegiate Athletes

Journal of Athletic Training ◽

10.4085/1062-6050-43.2.119 ◽

2008 ◽

Vol 43 (2) ◽

pp. 119-124 ◽

Cited By ~ 78

Author(s):

Tracey Covassin ◽

David Stearne ◽

Robert Elbin

Keyword(s):

Reaction Time ◽

Processing Speed ◽

Verbal Memory ◽

Visual Memory ◽

Collegiate Athletes ◽

Neurocognitive Performance ◽

Significant Group ◽

Repeated Measures Design ◽

History Of ◽

Concussion History

Abstract Context: Athletes are at an inherent risk for sustaining concussions. Research examining the long-term consequences of sport-related concussion has been inconsistent in demonstrating lingering neurocognitive decrements that may be associated with a previous history of concussion. Objective: To determine the relationship between concussion history and postconcussion neurocognitive performance and symptoms in collegiate athletes. Design: Repeated-measures design. Setting: Multi-center analysis of collegiate athletes. Patients or Other Participants: Fifty-seven concussed collegiate athletes (36 without concussion history, 21 with a history of 2 or more concussions). Intervention(s): All subjects were administered an Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) neurocognitive test battery, which measures verbal memory, visual memory, reaction time, and visual processing speed and 22 concussion symptoms. Main Outcome Measure(s): Subjects who sustained a concussion were administered 2 follow-up tests at days 1 and 5 postinjury. Independent variables were history of concussion (no history of concussion, 2 or more concussions) and time (baseline, day 1 postconcussion, or day 5 postconcussion). Results: A within-subjects effect (time) on ImPACT performance (P < .001), a between-subjects multivariate effect of group (P < .001), and a group-by-time interaction (P = .034) were noted. Athletes with a concussion history performed significantly worse on verbal memory (P = .01) and reaction time (P = .023) at day 5 postconcussion compared with athletes who did not report a previous concussion. No significant group differences were seen at day 5 postinjury on visual memory (P = .167), processing speed (P = .179), or total concussion symptoms (P = .87). Conclusions: Concussed collegiate athletes with a history of 2 or more concussions took longer to recover verbal memory and reaction time than athletes without a history of concussion.

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Between-Seasons Test-Retest Reliability of Clinically Measured Reaction Time in National Collegiate Athletic Association Division I Athletes

Journal of Athletic Training ◽

10.4085/1062-6050-46.4.409 ◽

2011 ◽

Vol 46 (4) ◽

pp. 409-414 ◽

Cited By ~ 42

Author(s):

James T. Eckner ◽

Jeffrey S. Kutcher ◽

James K. Richardson

Keyword(s):

Reaction Time ◽

Repeated Measures ◽

National Collegiate Athletic Association ◽

Collegiate Athletes ◽

Division I ◽

Clinical Test ◽

Retest Reliability ◽

Physical Examinations ◽

Division I Athletes ◽

Test Retest Reliability

Context: Reaction time is typically impaired after concussion. A clinical test of reaction time (RTclin) that does not require a computer to administer may be a valuable tool to assist in concussion diagnosis and management. Objective: To determine the test-retest reliability of RTclin measured over successive seasons in competitive collegiate athletes and to compare these results with a computerized measure of reaction time (RTcomp). Design: Case series with repeated measures. Setting: Preparticipation physical examinations for the football, women's soccer, and wrestling teams at a single university. Patients or Other Participants: 102 National Collegiate Athletic Association Division I athletes. Intervention(s): The RTclin was measured using a measuring stick embedded in a weighted rubber disk that was released and caught as quickly as possible. The RTcomp was measured using the simple reaction time component of CogState Sport. Main Outcome Measure(s): Data were collected at 2 time points, 1 season apart, during preparticipation physical examinations. Outcomes were mean simple RTclin and RTcomp. Results: The intraclass correlation coefficient estimates from season 1 to season 2 were 0.645 for RTclin (n = 102, entire sample) and 0.512 for RTcomp (n = 62 athletes who had 2 consecutive valid baseline CogState Sport test sessions). Conclusions: The test-retest reliability of RTclin over consecutive seasons compared favorably with that of a concurrently tested computerized measure of reaction time and with literature-based estimates of computerized reaction time measures. This finding supports the potential use of RTclin as part of a multifaceted concussion assessment battery. Further prospective study is warranted.

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Self-Reported Use and Opinions of Ankle Prophylaxes in Division III Collegiate Athletes: An Exploratory Study

International Journal of Athletic Therapy & Training ◽

10.1123/ijatt.2014-0130 ◽

2015 ◽

Vol 20 (6) ◽

pp. 51-57

Author(s):

Janet E. Simon ◽

Carrie L. Docherty

Keyword(s):

Ankle Sprain ◽

Exploratory Study ◽

Student Athletes ◽

Collegiate Athletes ◽

Ankle Injury ◽

Division Iii ◽

History Of

It is theorized that ankle taping is effective in reducing the incidence of a recurrent ankle injury. The purpose of this study was to explore perceptions of ankle taping in Division III athletes. Of student-athletes in the population studied, 321 returned surveys, of which 132 (41.1%) individuals indicated they have had their ankle(s) taped. Of the 132 individuals, 99 (75.0%) have had an ankle sprain. There were similar responses between both groups, particularly regarding not being able to tape (anxious about injury). Results of this study revealed that regardless of history of ankle injury, a majority of individuals stated they taped their ankle to prevent injury.

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Transient characteristics of body sway during single-leg stance in athletes with a history of ankle sprain

Gait & Posture ◽

10.1016/j.gaitpost.2021.03.022 ◽

2021 ◽

Author(s):

Žiga Kozinc ◽

Nebojša Trajković ◽

Nejc Šarabon

Keyword(s):

Ankle Sprain ◽

Body Sway ◽

Transient Characteristics ◽

Single Leg Stance ◽

History Of

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Running Biomechanics Before Injury and 1 Year After Anterior Cruciate Ligament Reconstruction in Division I Collegiate Athletes

The American Journal of Sports Medicine ◽

10.1177/03635465211026665 ◽

2021 ◽

pp. 036354652110266

Author(s):

Keith A. Knurr ◽

Stephanie A. Kliethermes ◽

Mikel R. Stiffler-Joachim ◽

Daniel G. Cobian ◽

Geoffrey S. Baer ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Cruciate Ligament ◽

Knee Extensor ◽

Collegiate Athletes ◽

Treadmill Running ◽

Division I ◽

P Values ◽

Peak Knee ◽

Anterior Cruciate ◽

Running Biomechanics

Background: Preinjury running biomechanics are an ideal comparator for quantifying recovery after anterior cruciate ligament (ACL) reconstruction (ACLR), allowing for assessments within the surgical and nonsurgical limbs. However, availability of preinjury running biomechanics is rare and has been reported in case studies only. Purpose/Hypothesis: The purpose of this study was to determine if running biomechanics return to preinjury levels within the first year after ACLR among collegiate athletes. We hypothesized that (1) surgical knee biomechanics would be significantly reduced shortly after ACLR and would not return to preinjury levels by 12 months and (2) nonsurgical limb mechanics would change significantly from preinjury. Study Design: Cohort study; Level of evidence, 2. Methods: Thirteen Division I collegiate athletes were identified between 2015 and 2020 (6 female; mean ± SD age, 20.7 ± 1.3 years old) who had whole body kinematics and ground-reaction forces recorded during treadmill running (3.7 ± 0.6 m/s) before sustaining an ACL injury. Running analyses were repeated at 4, 6, 8, and 12 months (4M, 6M, 8M, 12M) after ACLR. Linear mixed effects models were used to assess differences in running biomechanics between post-ACLR time points and preinjury within each limb, reported as Tukey-adjusted P values. Results: When compared with preinjury, the surgical limb displayed significant deficits at all postoperative assessments ( P values <.01; values reported as least squares mean difference [SE]): peak knee flexion angle (4M, 13.2° [1.4°]; 6M, 9.9° [1.4°]; 8M, 9.8° [1.4°]; 12M, 9.0° [1.5°]), peak knee extensor moment (N·m/kg; 4M, 1.32 [0.13]; 6M, 1.04 [0.13]; 8M, 1.04 [0.13]; 12M, 0.87 [0.15]; 38%-57% deficit), and rate of knee extensor moment (N·m/kg/s; 4M, 22.7 [2.4]; 6M, 17.9 [2.3]; 8M, 17.5 [2.4]; 12M, 16.1 [2.6]; 33%-46% deficit). No changes for these variables from preinjury ( P values >.88) were identified in the nonsurgical limb. Conclusion: After ACLR, surgical limb knee running biomechanics were not restored to the preinjury state by 12M, while nonsurgical limb mechanics remained unchanged as compared with preinjury. Collegiate athletes after ACLR demonstrate substantial deficits in running mechanics as compared with preinjury that persist beyond the typical return-to-sport time frame. The nonsurgical knee appears to be a valid reference for recovery of the surgical knee mechanics during running, owing to the lack of change within the nonsurgical limb.

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Muscle Strength Deficit though Intact Proprioception after Lateral Ankle Sprain without Persistent Instability

Physikalische Medizin Rehabilitationsmedizin Kurortmedizin ◽

10.1055/a-1333-3638 ◽

2021 ◽

Author(s):

Adel M. Madkhali ◽

Shibili Nuhmani

Keyword(s):

Ankle Sprain ◽

Peak Torque ◽

Position Sense ◽

Joint Position Sense ◽

Joint Position ◽

Lateral Ankle Sprain ◽

Lateral Ankle ◽

Cohen’S D ◽

History Of ◽

Cohen's D

Abstract Background Lateral ankle sprain is one of the most common injuries in competitive sports. Previous studies which investigated muscle strength and proprioception (joint position sense) focused on subjects who sustained ankle sprain with instability. It is also important to investigate strength deficits and proprioception in subjects with a history of ankle sprain without instability. Therefore the aim of the study is to investigate proprioception and muscle strength deficits in athletes with lateral ankle sprain. Methods Twenty-four male athletes with a history of lateral ankle sprain and 24 age-matched controls (mean age of 22.42±4.13 years, mean height of 173±5.73 cm, and mean weight of 71.20±7.55 Kg) participated in this cross-sectional study. Peak torque and peak torque ratio at speeds of 30 and 120°/s for concentric and eccentric ankle inversion/eversion were evaluated using an isokinetic dynamometer. The joint position sense of the ankle joint was evaluated using an active angle reproduction test. Result Peak torque produced was significantly less in subjects with history of ankle sprain in concentric inversion 30°/s(t(47)=4.11; p=0.000, Cohen’s d=1.29), concentric inversion 120°/s (t(47)=3.01; p=0.006, Cohen’s d=1.13), concentric eversion 30°/s (t(47)=3.85; p=0.001, Cohen’s d=1.24) and concentric eversion 120°/s (t(47)=3.15; p=0.005, Cohen’s d=1.09). At the same time there was no significant difference observed in eccentric eversion peak torque in both speed (eccentric eversion 30°/s p=0.079; eccentric eversion 120°/s p=0.867) between experimental and control group. No significant difference was found in the joint position sense in the maximal active inversion −5° position (p=0.312) and the 15° inversion position (P=0.386) between both group. Conclusion The study’s results reported a significantly less peak torque of invertors and evertors during concentric movements in athletes with history of ankle sprain. At the same time, no significant difference reported in the evertor/invertor peak torque ratio, and active joint position sense between the 2 groups.

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