Examining the Relationship Between a Neuromuscular Control Baseline Battery for Sport-Related Concussion and Anterior Cruciate Ligament Injury Risk

Neurology ◽  
2021 ◽  
Vol 98 (1 Supplement 1) ◽  
pp. S21.2-S22
Author(s):  
Ryan Moran

ObjectiveTo examine the relationship between the m-CTSIB and Landing Error Scoring System in a sample of collegiate female athletes.BackgroundRecent literature has linked concussion and neuromuscular deficits in the lower extremity after injury. Neuromuscular control is frequently assessed using balance measures for concussion, but also dynamically to identify anterior cruciate ligament injury (ACL) risk via jump-landing movement screening.Design/MethodsThirty-nine healthy, collegiate female soccer (n = 22) and volleyball (n = 17) athletes completed the modified-Clinical Test of Sensory Interaction of Balance (m-CTSIB) and the Landing Error Scoring System (LESS). Measures consisted of total m-CTSIB sway index scores on individual conditions (firm surface eyes open [condition 1] and eyes closed [2], foam surface eyes open [3] and eyes closed [4]), m-CTSIB overall score, and total LESS errors. LESS scores were also categorized into a low (0–4 errors) and high (5 + errors) risk to determine if athletes with worse neuromuscular control on the LESS has worse balance on the m-CTSIB. A Spearman's rank-order correlation was conducted to determine the strength of the relationship between LESS and m-CTSIB performance. A series of Mann-Whitney U test were performed to determine differences between low and high LESS performance on m-CTSIB performance.ResultsThere was a weak, negative correlation between LESS and m-CTSIB performance (rs(37) = −0.153, p = 0.35). Further, there were no differences between the low and high risk LESS groups on sway index scores on conditions 1 (U = 158.5, p = 0.39), 2 (U = 156.0, p = 0.36), 3 (U = 165.5, p = 0.51), or 4 (U = 128.5, p = 0.08), as well as overall m-CTSIB scores (U = 150.5, p = 0.28).ConclusionsThere appears to be a lack of relationship between the LESS and m-CTSIB tests, revealing the independence of static and dynamic lower extremity neuromuscular function. Athletes who may be more at risk for ACL injury due to abnormal jump-landing biomechanics, do not differ from low-risk athletes on baseline balance assessment.

2005 ◽  
Vol 33 (4) ◽  
pp. 492-501 ◽  
Author(s):  
Timothy E. Hewett ◽  
Gregory D. Myer ◽  
Kevin R. Ford ◽  
Robert S. Heidt ◽  
Angelo J. Colosimo ◽  
...  

Background Female athletes participating in high-risk sports suffer anterior cruciate ligament injury at a 4- to 6-fold greater rate than do male athletes. Hypothesis Prescreened female athletes with subsequent anterior cruciate ligament injury will demonstrate decreased neuromuscular control and increased valgus joint loading, predicting anterior cruciate ligament injury risk. Study Design Cohort study; Level of evidence, 2. Methods There were 205 female athletes in the high-risk sports of soccer, basketball, and volleyball prospectively measured for neuromuscular control using 3-dimensional kinematics (joint angles) and joint loads using kinetics (joint moments) during a jump-landing task. Analysis of variance as well as linear and logistic regression were used to isolate predictors of risk in athletes who subsequently ruptured the anterior cruciate ligament. Results Nine athletes had a confirmed anterior cruciate ligament rupture; these 9 had significantly different knee posture and loading compared to the 196 who did not have anterior cruciate ligament rupture. Knee abduction angle (P <. 05) at landing was 8° greater in anterior cruciate ligament-injured than in uninjured athletes. Anterior cruciate ligament-injured athletes had a 2.5 times greater knee abduction moment (P <. 001) and 20% higher ground reaction force (P <. 05), whereas stance time was 16% shorter; hence, increased motion, force, and moments occurred more quickly. Knee abduction moment predicted anterior cruciate ligament injury status with 73% specificity and 78% sensitivity; dynamic valgus measures showed a predictive r2 of 0.88. Conclusion Knee motion and knee loading during a landing task are predictors of anterior cruciate ligament injury risk in female athletes. Clinical Relevance Female athletes with increased dynamic valgus and high abduction loads are at increased risk of anterior cruciate ligament injury. The methods developed may be used to monitor neuromuscular control of the knee joint and may help develop simpler measures of neuromuscular control that can be used to direct female athletes to more effective, targeted interventions.


2006 ◽  
Vol 34 (5) ◽  
pp. 757-764 ◽  
Author(s):  
Bruce D. Beynnon ◽  
Robert J. Johnson ◽  
Stuart Braun ◽  
Mike Sargent ◽  
Ira M. Bernstein ◽  
...  

2016 ◽  
pp. S409-S416 ◽  
Author(s):  
Z. HIRJAKOVÁ ◽  
H. ŠINGLIAROVÁ ◽  
D. BZDÚŠKOVÁ ◽  
J. KIMIJANOVÁ ◽  
K. BUČKOVÁ ◽  
...  

The aim of the study was to evaluate the effect of surgical reconstruction of anterior cruciate ligament (ACL) on postural stability and responses to lower limb (LL) muscles vibrations. Centre of pressure (CoP) was measured in 17 subjects during stance on firm/foam surface with eyes open/closed and during unilateral vibrations of LL muscles (m. triceps surae – TS, m. quadriceps femoris – Q, m. quadriceps femoris and hamstrings simultaneously – QH). The measurements were performed: 1) preoperatively, 2) six weeks and 3) three months after the reconstruction. Decreased postural stability was documented six weeks after the reconstruction compared to preoperative measurement. Three months after the reconstruction significant improvement was observed during stance on foam surface with eyes closed. Preoperatively, altered reactions of LL with ACL lesion compared to intact LL were manifested by slower response in first 3 s of TS vibration and by increased CoP shift in last 5 s of QH vibration. After the reconstruction, we observed slower CoP reaction and decreased CoP shift during TS vibration of LL with ACL lesion compared to preoperative level. Posturography during quiet stance and during TS vibration reliably detect postural changes due to ACL reconstruction and can be potentially useful in clinical practice.


2020 ◽  
pp. 1-7
Author(s):  
Francesca Genoese ◽  
Shelby E. Baez ◽  
Nicholas Heebner ◽  
Matthew C. Hoch ◽  
Johanna M. Hoch

Context: Deficits in reaction time, decreased self-reported knee function, and elevated levels of injury-related fear have been observed in individuals who sustain anterior cruciate ligament injury. Understanding the relationship between these variables may provide the impetus to further investigate effective intervention strategies to address these deficits in individuals after anterior cruciate ligament reconstruction (ACLR). Objective: To examine the relationship between injury-related fear and lower-extremity visuomotor reaction time (VMRT) in individuals with a history of ACLR. A secondary purpose was to determine the relationship between self-reported knee function and lower-extremity VMRT in individuals with a history of ACLR. Design: Cross-sectional study. Setting: Laboratory. Participants: Twenty participants between the ages of 18–35 years, with history of unilateral ACLR within the last 10 years, who injured their knee playing or training for organized or recreational sports. Main Outcome Measures: Scores on the athlete fear avoidance questionnaire, the fear-avoidance beliefs questionnaire (FABQ), the knee injury and osteoarthritis outcome score, and reaction time (in seconds) on the lower-extremity VMRT task using the FitLight Trainer™, bilaterally. Spearman Rho correlations examined the relationship between the dependent variables. Results: There was a moderate positive correlation between VMRT and FABQ-total (r = .62, P < .01), FABQ-sport (r = .56, P = .01), and FABQ-physical activity (r = .64, P < .01) for the injured limb. Correlations between FABQ scores and VMRT for the uninjured limb were weak positive correlations (r = .36–.41, P > .05). Weak correlations between the osteoarthritis outcome score subscales, athlete fear avoidance questionnaire, and VMRT were observed for the injured limb (P > .05). Conclusions: Individuals with a history of ACLR who exhibited elevated levels of injury-related fear demonstrated slower VMRT. There were no relationships between self-reported knee function and VMRT. Future research should explore interventions to address injury-related fear and VMRT in individuals after ACLR.


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