Effects of cognitive- and motor-dual tasks on postural control regularity following anterior cruciate ligament reconstruction
High injury rates following anterior cruciate ligament reconstruction (ACLR) motivate the need to better understand lingering movement deficiencies following return to sport. Athletic competition involves various types of sensory, motor, and cognitive challenges; however, postural control deficienci...
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| Veröffentlicht in: | Gait & posture 2022-09, Vol.97, p.109-114 |
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| creator | Monfort, Scott M. Simon, Janet E. Miko, Sarah C. Grooms, Dustin R. |
| description | High injury rates following anterior cruciate ligament reconstruction (ACLR) motivate the need to better understand lingering movement deficiencies following return to sport. Athletic competition involves various types of sensory, motor, and cognitive challenges; however, postural control deficiencies during this spectrum of conditions are not well understood following ACLR.
To what extent is postural control altered following ACLR in the presence of sensory, motor, and cognitive challenges, and does postural control correlate with patient-reported symptoms?
Fourteen individuals following ACLR (4 m/10 f, 21.2 ± 2.4 yr, 76.9 ± 19.1 kg, 1.70 ± 0.14 m) and fourteen matched healthy controls (4 m/10 f, 21.2 ± 1.4 yr, 75.4 ± 15.3 kg, 1.70 ± 0.15 m) participated in the study. Participants completed single-leg balance, ACLR limb or matched side for controls, under four conditions: 1) eyes open, 2) eyes closed, 3) visual-cognitive dual task (i.e., reverse digit span), and 4) motor dual task (i.e., catching a ball). Sample entropy (SEn) was calculated for each balance condition to characterize regularity of center of pressure control. Participants also completed patient-reported outcomes to characterize self-reported knee function, symptoms, and fear. A mixed effects model tested for differences in SEn between balance conditions, and Spearman correlations tested for relationships between SEn and patient-reported outcomes.
A significant Group-by-Condition interaction was detected (P = 0.043). While the motor dual task and eyes closed balance conditions were associated with the lowest SEn for both groups, only the visual-cognitive dual task condition demonstrated a significant difference between groups, with the ACLR group having lower SEn [95% confidence interval for ΔSEn: (0.03, 0.35)]. Lower KOOS-Sport scores were associated with decreased SEn for the ACLR group (ρ = 0.81, P |
| doi_str_mv | 10.1016/j.gaitpost.2022.07.246 |
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To what extent is postural control altered following ACLR in the presence of sensory, motor, and cognitive challenges, and does postural control correlate with patient-reported symptoms?
Fourteen individuals following ACLR (4 m/10 f, 21.2 ± 2.4 yr, 76.9 ± 19.1 kg, 1.70 ± 0.14 m) and fourteen matched healthy controls (4 m/10 f, 21.2 ± 1.4 yr, 75.4 ± 15.3 kg, 1.70 ± 0.15 m) participated in the study. Participants completed single-leg balance, ACLR limb or matched side for controls, under four conditions: 1) eyes open, 2) eyes closed, 3) visual-cognitive dual task (i.e., reverse digit span), and 4) motor dual task (i.e., catching a ball). Sample entropy (SEn) was calculated for each balance condition to characterize regularity of center of pressure control. Participants also completed patient-reported outcomes to characterize self-reported knee function, symptoms, and fear. A mixed effects model tested for differences in SEn between balance conditions, and Spearman correlations tested for relationships between SEn and patient-reported outcomes.
A significant Group-by-Condition interaction was detected (P = 0.043). While the motor dual task and eyes closed balance conditions were associated with the lowest SEn for both groups, only the visual-cognitive dual task condition demonstrated a significant difference between groups, with the ACLR group having lower SEn [95% confidence interval for ΔSEn: (0.03, 0.35)]. Lower KOOS-Sport scores were associated with decreased SEn for the ACLR group (ρ = 0.81, P < 0.001).
These findings are consistent with ACLR individuals using a less automatic approach to postural control compared to controls, particularly when presented with a visual-cognitive challenge. Altered neuromuscular control persists well after ACLR surgery and can be related to patient-reported outcomes.
•A motor dual task elicited the greatest balance alterations for both groups.•Altered postural control was seen at least one year following ACLR.•Differences between ACLR and controls were isolated to the cognitive dual task.•CoP regularity during cognitive dual task associated with knee function after ACLR.</description><identifier>ISSN: 0966-6362</identifier><identifier>EISSN: 1879-2219</identifier><identifier>DOI: 10.1016/j.gaitpost.2022.07.246</identifier><identifier>PMID: 35917701</identifier><language>eng</language><publisher>England: Elsevier B.V</publisher><subject>ACLR ; Anterior Cruciate Ligament Injuries - surgery ; Anterior Cruciate Ligament Reconstruction ; Balance ; Cognition ; Humans ; Knee Joint ; Postural Balance ; Sample entropy ; Visual-cognition</subject><ispartof>Gait & posture, 2022-09, Vol.97, p.109-114</ispartof><rights>2022 Elsevier B.V.</rights><rights>Copyright © 2022 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3316-746b0c1c89232a899866147772a8798804463a09c9c70b80c79b770c8a4aef223</citedby><cites>FETCH-LOGICAL-c3316-746b0c1c89232a899866147772a8798804463a09c9c70b80c79b770c8a4aef223</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0966636222004519$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35917701$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Monfort, Scott M.</creatorcontrib><creatorcontrib>Simon, Janet E.</creatorcontrib><creatorcontrib>Miko, Sarah C.</creatorcontrib><creatorcontrib>Grooms, Dustin R.</creatorcontrib><title>Effects of cognitive- and motor-dual tasks on postural control regularity following anterior cruciate ligament reconstruction</title><title>Gait & posture</title><addtitle>Gait Posture</addtitle><description>High injury rates following anterior cruciate ligament reconstruction (ACLR) motivate the need to better understand lingering movement deficiencies following return to sport. Athletic competition involves various types of sensory, motor, and cognitive challenges; however, postural control deficiencies during this spectrum of conditions are not well understood following ACLR.
To what extent is postural control altered following ACLR in the presence of sensory, motor, and cognitive challenges, and does postural control correlate with patient-reported symptoms?
Fourteen individuals following ACLR (4 m/10 f, 21.2 ± 2.4 yr, 76.9 ± 19.1 kg, 1.70 ± 0.14 m) and fourteen matched healthy controls (4 m/10 f, 21.2 ± 1.4 yr, 75.4 ± 15.3 kg, 1.70 ± 0.15 m) participated in the study. Participants completed single-leg balance, ACLR limb or matched side for controls, under four conditions: 1) eyes open, 2) eyes closed, 3) visual-cognitive dual task (i.e., reverse digit span), and 4) motor dual task (i.e., catching a ball). Sample entropy (SEn) was calculated for each balance condition to characterize regularity of center of pressure control. Participants also completed patient-reported outcomes to characterize self-reported knee function, symptoms, and fear. A mixed effects model tested for differences in SEn between balance conditions, and Spearman correlations tested for relationships between SEn and patient-reported outcomes.
A significant Group-by-Condition interaction was detected (P = 0.043). While the motor dual task and eyes closed balance conditions were associated with the lowest SEn for both groups, only the visual-cognitive dual task condition demonstrated a significant difference between groups, with the ACLR group having lower SEn [95% confidence interval for ΔSEn: (0.03, 0.35)]. Lower KOOS-Sport scores were associated with decreased SEn for the ACLR group (ρ = 0.81, P < 0.001).
These findings are consistent with ACLR individuals using a less automatic approach to postural control compared to controls, particularly when presented with a visual-cognitive challenge. Altered neuromuscular control persists well after ACLR surgery and can be related to patient-reported outcomes.
•A motor dual task elicited the greatest balance alterations for both groups.•Altered postural control was seen at least one year following ACLR.•Differences between ACLR and controls were isolated to the cognitive dual task.•CoP regularity during cognitive dual task associated with knee function after ACLR.</description><subject>ACLR</subject><subject>Anterior Cruciate Ligament Injuries - surgery</subject><subject>Anterior Cruciate Ligament Reconstruction</subject><subject>Balance</subject><subject>Cognition</subject><subject>Humans</subject><subject>Knee Joint</subject><subject>Postural Balance</subject><subject>Sample entropy</subject><subject>Visual-cognition</subject><issn>0966-6362</issn><issn>1879-2219</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkM1OJCEUhYlxoq0zr2BYuqkaoEp-dhrjzyQmbmbWhKZuVWgpaIHSuPDdh06rW1fk3nyHk_shdEZJSwnlvzftZFzZxlxaRhhriWhZzw_QikqhGsaoOkQrojhveMfZMTrJeUMI6TvJjtBxd6GoEISu0PvNOIItGccR2zgFV9wLNNiEAc-xxNQMi_G4mPxUkYB3hUuqGxtDSdHjBNPiTXLlDY_R-_jqwlTTBZKLCdu0WGcKYO8mM0Mola_JXOq-uBh-oh-j8Rl-fbyn6N_tzd_r--bh8e7P9dVDY7uO8kb0fE0stVKxjhmplOSc9kKIOgglJel73hmirLKCrCWxQq3reVaa3sDIWHeKzvf_blN8XiAXPbtswXsTIC5ZM64EFxdSyYryPWpTzDnBqLfJzSa9aUr0Tr3e6E_1eqdeE6Gr-ho8--hY1jMMX7FP1xW43ANQL31xkHS2DoKFwVUrRQ_RfdfxH13vmt4</recordid><startdate>202209</startdate><enddate>202209</enddate><creator>Monfort, Scott M.</creator><creator>Simon, Janet E.</creator><creator>Miko, Sarah C.</creator><creator>Grooms, Dustin R.</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202209</creationdate><title>Effects of cognitive- and motor-dual tasks on postural control regularity following anterior cruciate ligament reconstruction</title><author>Monfort, Scott M. ; Simon, Janet E. ; Miko, Sarah C. ; Grooms, Dustin R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3316-746b0c1c89232a899866147772a8798804463a09c9c70b80c79b770c8a4aef223</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>ACLR</topic><topic>Anterior Cruciate Ligament Injuries - surgery</topic><topic>Anterior Cruciate Ligament Reconstruction</topic><topic>Balance</topic><topic>Cognition</topic><topic>Humans</topic><topic>Knee Joint</topic><topic>Postural Balance</topic><topic>Sample entropy</topic><topic>Visual-cognition</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Monfort, Scott M.</creatorcontrib><creatorcontrib>Simon, Janet E.</creatorcontrib><creatorcontrib>Miko, Sarah C.</creatorcontrib><creatorcontrib>Grooms, Dustin R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Gait & posture</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Monfort, Scott M.</au><au>Simon, Janet E.</au><au>Miko, Sarah C.</au><au>Grooms, Dustin R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of cognitive- and motor-dual tasks on postural control regularity following anterior cruciate ligament reconstruction</atitle><jtitle>Gait & posture</jtitle><addtitle>Gait Posture</addtitle><date>2022-09</date><risdate>2022</risdate><volume>97</volume><spage>109</spage><epage>114</epage><pages>109-114</pages><issn>0966-6362</issn><eissn>1879-2219</eissn><abstract>High injury rates following anterior cruciate ligament reconstruction (ACLR) motivate the need to better understand lingering movement deficiencies following return to sport. Athletic competition involves various types of sensory, motor, and cognitive challenges; however, postural control deficiencies during this spectrum of conditions are not well understood following ACLR.
To what extent is postural control altered following ACLR in the presence of sensory, motor, and cognitive challenges, and does postural control correlate with patient-reported symptoms?
Fourteen individuals following ACLR (4 m/10 f, 21.2 ± 2.4 yr, 76.9 ± 19.1 kg, 1.70 ± 0.14 m) and fourteen matched healthy controls (4 m/10 f, 21.2 ± 1.4 yr, 75.4 ± 15.3 kg, 1.70 ± 0.15 m) participated in the study. Participants completed single-leg balance, ACLR limb or matched side for controls, under four conditions: 1) eyes open, 2) eyes closed, 3) visual-cognitive dual task (i.e., reverse digit span), and 4) motor dual task (i.e., catching a ball). Sample entropy (SEn) was calculated for each balance condition to characterize regularity of center of pressure control. Participants also completed patient-reported outcomes to characterize self-reported knee function, symptoms, and fear. A mixed effects model tested for differences in SEn between balance conditions, and Spearman correlations tested for relationships between SEn and patient-reported outcomes.
A significant Group-by-Condition interaction was detected (P = 0.043). While the motor dual task and eyes closed balance conditions were associated with the lowest SEn for both groups, only the visual-cognitive dual task condition demonstrated a significant difference between groups, with the ACLR group having lower SEn [95% confidence interval for ΔSEn: (0.03, 0.35)]. Lower KOOS-Sport scores were associated with decreased SEn for the ACLR group (ρ = 0.81, P < 0.001).
These findings are consistent with ACLR individuals using a less automatic approach to postural control compared to controls, particularly when presented with a visual-cognitive challenge. Altered neuromuscular control persists well after ACLR surgery and can be related to patient-reported outcomes.
•A motor dual task elicited the greatest balance alterations for both groups.•Altered postural control was seen at least one year following ACLR.•Differences between ACLR and controls were isolated to the cognitive dual task.•CoP regularity during cognitive dual task associated with knee function after ACLR.</abstract><cop>England</cop><pub>Elsevier B.V</pub><pmid>35917701</pmid><doi>10.1016/j.gaitpost.2022.07.246</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | ACLR Anterior Cruciate Ligament Injuries - surgery Anterior Cruciate Ligament Reconstruction Balance Cognition Humans Knee Joint Postural Balance Sample entropy Visual-cognition |
| title | Effects of cognitive- and motor-dual tasks on postural control regularity following anterior cruciate ligament reconstruction |
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