Neurocognitive Function Associated With Knee Proprioception And Time To Stability After Anterior Cruciate Ligament Reconstruction

Abstract

After ACL injury, simple knee motor control requires greater sensory integration and cognitive resources relative to healthy counterparts. However, little is known about how visual neurocognitive function relates to knee proprioception and dynamic stability after ACL reconstruction (ACLR). PURPOSE: Evaluate the association between visually mediated neurocognitive function, knee proprioception, and time to stabilize from a single-leg landing in ACLR and healthy participants. METHODS: Sixteen individuals with history of left unilateral ACL reconstruction (6 male, 21.5 ± 2.6 years, 69 ± 15.9 kg, Tegner 7.4 ± 1.1, time since surgery 41.4 ± 33.0 months) and 15 healthy controls (6 male, 22.9 ± 3.03 years, 70.9 ± 14.9 kg, Tegner 7.5 ± 1.1) were recruited. Visually mediated neurocognitive function measured by the Immediate Post-Concussion Assessment and Cognitive Testing computerized test (visual memory and visual motor subscales). Active joint position sense (AJPS) was assessed using an electromechanical dynamometer at 20° and a double leg jump to left (involved) leg landing was used to assess time to stability (TTS). Raw ImPACT subscale scores, average AJPS error, and average TTS of 3 trials were used for statistical analysis. Independent samples t-tests were used to compare means of dependent variables (ImPACT subscales, AJPS, TTS) between groups. Pearson’s correlation (r) was used to determine the relationship between visual memory and AJPS; and visual motor scores and TTS in the control group. Partial correlations controlling for time since surgery on the same variables were used for the ACL group. RESULTS: There was no between group differences for any of the dependent variables (p > 0.05). ImPACT visual memory and visual motor scores were negatively associated with proprioceptive error (r = -0.63), and time to stability (r = -0.61), respectively in the ACL group but not in the control group. CONCLUSIONS: After ACLR higher visual memory scores were associated with less AJPS error (better proprioception) and higher visual motor ability was associated with decreased time to stabilize from landing (better performance). Individuals after ACLR might use visually mediated neurocognitive attention to maintain performance in AJPS and TTS.