Preliminary Report on the Train the Brain Project: Sensorimotor Neural Correlates of Anterior Cruciate Ligament Injury Risk Biomechanics - Part I

Context:Anterior cruciate ligament (ACL) injury commonly occurs via non-contact motor coordination errors resulting in excessive multiplanar loading during athletic movements. Preventing motor coordination errors requires neural sensorimotor integration activity to support knee joint neuromuscular control, but the underlying neural mechanisms driving injury risk motor control are not well understood.Objective:To evaluate brain activity differences for knee sensorimotor control between athletes with high and low injury risk mechanics.Design: Case-control study.Setting:Research laboratoryParticipants:Thirty-eight female high school soccer players were screened and ten selected for analysis based on MRI compliance, injury-risk classification via 3D biomechanics during a drop vertical jump, and matching criteria to complete neuroimaging during knee motor tasks.Main Outcome Measures:Peak knee abduction moment during landing was utilized for group determination into high injury risk (≥21.74 Nm, n=9) and low injury risk (≤10.6 Nm, n=11) classification (n=11 uncategorized, n=7 non-MRI compliant). Ten participants (5-high risk, 5-low risk) with adequate data were able to be matched and compared across two neuroimaging paradigms, unilateral knee joint control and unilateral multi-joint leg press against resistance.Results:Athletes with high injury risk biomechanics had lower neural activity in one sensory-motor cluster for isolated knee joint control (precuneus, peak z-score: 4.14, p≤0.01, 788 voxels) and greater brain activity for the multi-joint leg press in two cognitive-motor clusters: frontal cortex (peak z-score: 4.71, p