Abstract
Background
A large majority of anterior cruciate ligament (ACL) injuries are non-contact, most
often occurring during a landing or change of direction. Recent research indicates
that cognitive factors may be involved in non-contact ACL injuries. The aim of this
study was to determine if a game-situation perceptual–cognitive load leads to altered
landing kinematics in physically fatigued female athletes.
Methods
Nineteen female recreational athletes were recruited to perform a series of jumping
and landing trials. In a first phase, eight trials were performed in an isolated condition
and eight were performed while participants performed a perceptual–cognitive task.
Before a second identical phase, participants underwent a muscular fatigue protocol.
Knee-joint kinematics were recorded and compared between conditions using paired t-tests.
Results
Muscle fatigue led to statistically significant increases in peak knee abduction and
peak internal knee rotation as well as a decrease in maximum knee flexion, when comparing
conditions without the perceptual–cognitive task. The perceptual–cognitive task had
no statistically significant effect on any knee rotations, either pre- or post-fatigue.
However, a subgroup of 12 athletes showed a significant increase in knee abduction
in the presence of the perceptual–cognitive task, only in the fatigued condition.
Conclusion
A perceptual–cognitive task combined with muscle fatigue alters knee kinematics of
landing for a subset of recreational athletes, potentially increasing the risk of
ACL rupture. Further studies are necessary to confirm this finding and to identify
characteristics of at-risk individuals to target them for injury prevention protocols.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The KneeAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Understanding and preventing noncontact anterior cruciate ligament injuries: a review of the Hunt Valley II Meeting, January 2005.Am J Sports Med. 2006; 34: 1512-1532https://doi.org/10.1177/0363546506286866
- Mechanisms of anterior cruciate ligament injury.Orthopedics. 2000; 23: 573-578https://doi.org/10.1016/j.ptsp.2008.01.002
- A prospective cohort study of anterior cruciate ligament injuries in elite Norwegian team handball.Scand J Med Sci Sports. 1998; 8: 149-153https://doi.org/10.1111/j.1600-0838.1998.tb00185.x
- Mechanisms of noncontact anterior cruciate ligament injury.J Athl Train. 2008; 43: 396-408https://doi.org/10.4085/1062-6050-43.4.396
- Anterior cruciate ligament injury in national collegiate athletic association basketball and soccer: a 13-year review.Am J Sports Med. 2005; 33: 524-531
- Injury mechanisms for anterior cruciate ligament injuries in team handball: a systematic video analysis.Am J Sports Med. 2004; 32: 1002-1012https://doi.org/10.1177/0363546503261724
- Mechanisms of anterior cruciate ligament injury in basketball: video analysis of 39 cases.Am J Sports Med. 2007; 35: 359-367https://doi.org/10.1177/0363546506293899
- Prevention of non-contact anterior cruciate ligament injuries in soccer players. Part 1: mechanisms of injury and underlying risk factors.Knee Surg Sports Traumatol Arthrosc. 2009; 17: 705-729
- Prevention of non-contact anterior cruciate ligament injuries in sports. Part II: systematic review of the effectiveness of prevention programmes in male athletes.Knee Surg Sports Traumatol Arthrosc. 2014; 22: 16-25https://doi.org/10.1007/s00167-013-2739-x
- Quadriceps and hamstrings fatigue alters hip and knee mechanics.J Appl Biomech. 2010; 26: 159-170
- Combined effects of fatigue and decision making on female lower limb landing postures: central and peripheral contributions to ACL injury risk.Clin Biomech. 2008; 23: 81-92https://doi.org/10.1016/j.clinbiomech.2007.08.008
- Fatigue-induced ACL injury risk stems from a degradation in central control.Med Sci Sports Exerc. 2009; 41: 1661
- Effects of two neuromuscular fatigue protocols on landing performance.J Electromyogr Kinesiol. 2010; 20: 667-675https://doi.org/10.1016/j.jelekin.2009.10.007
- Gender differences in lower extremity landing mechanics caused by neuromuscular fatigue.Am J Sports Med. 2007; 36: 554-565
- Impact of fatigue on gender-based high-risk landing strategies.Med Sci Sports Exerc. 2007; 39: 502-514https://doi.org/10.1249/mss.0b013e3180d47f0
- Injury risk associated with playing actions during competitive soccer.Br J Sports Med. 2002; 36: 354-359https://doi.org/10.1136/bjsm.36.5.354
- The association football medical research programme: an audit of injuries in professional football.Br J Sports Med. 2001; 35: 43-47https://doi.org/10.1136/bjsm.35.1.43
- Understanding injury mechanisms: a key component of preventing injuries in sport.Br J Sports Med. 2005; 39: 324-329https://doi.org/10.1136/bjsm.2005.018341
- The effects of anticipation on the mechanics of the knee during single-leg cutting tasks: a systematic review.Int J Sports Phys Ther. 2015; 10: 918-928
- Effect of anticipation on lower extremity biomechanics during side- and cross-cutting maneuvers in young soccer players.Am J Sports Med. 2014; 42: 1985-1992https://doi.org/10.1177/0363546514531578
- Anticipatory postural adjustments during cutting manoeuvres in football and their consequences for knee injury risk.J Sports Sci. 2014; 32: 1255-1262https://doi.org/10.1080/02640414.2013.876508
- Effects of neuromuscular fatigue on perceptual-cognitive skills between genders in the contribution to the knee joint loading during side-stepping tasks.J Sports Sci. 2015; 414: 1-10https://doi.org/10.1080/02640414.2014.990485
- Lower limb muscle pre-motor time measures during a choice reaction task associate with knee abduction loads during dynamic single leg landings.Clin Biomech. 2010; 25: 563-569https://doi.org/10.1016/j.clinbiomech.2010.02.013
- The relationship between neurocognitive function and noncontact anterior cruciate ligament injuries.Am J Sports Med. 2007; 35: 943-948
- Expertise and perceptual-cognitive performance in soccer: a review.Rev Port Ciências Do Desporto. 2009; 9: 115-122
- Tracking multiple independent targets: evidence for a parallel tracking mechanism*.Spat Vis. 1988; 3: 179-197
- Perceptual–cognitive training of athletes.J Clin Sport Psychol. 2012; 6: 85-102
- 3D-Multiple Object Tracking training task improves passing decision-making accuracy in soccer players.Psychol Sport Exerc. 2016; 22: 1-9https://doi.org/10.1016/j.psychsport.2015.06.002
- Visual tracking speed is related to basketball-specific measures of performance in NBA players.J Strength Cond Res. 2014; 28: 2406-2414https://doi.org/10.1519/JSC.0000000000000550
- Sex-dimorphic landing mechanics and their role within the noncontact ACL injury mechanism: evidence, limitations and directions.Sport Med Arthrosc Rehabil Ther Technol SMARTT. 2012; 4: 10
- A meta-analysis of the incidence of anterior cruciate ligament tears as a function of gender, sport, and a knee injury-reduction regimen.Arthroscopy. 2007; 23: 1320-1325.e6
- A reproducible method for studying three-dimensional knee kinematics.J Biomech. 2005; 38: 1926-1931
- Transformed up-down methods in psychoacoustics.J Acoust Soc Am. 1971; : 467-477https://doi.org/10.1121/1.1912375
- A joint coordinate system for the clinical description of three-dimensional motions: application to the knee.J Biomech Eng. 1983; 105: 136-144https://doi.org/10.1115/1.3138397
- Gender and fatigue have influence on knee joint control strategies during landing.Clin Biomech. 2009; 24: 82-87https://doi.org/10.1016/j.clinbiomech.2008.07.005
- Valgus plus internal rotation moments increase anterior cruciate ligament strain more than either alone.Med Sci Sports Exerc. 2011; 43: 1484-1491https://doi.org/10.1249/MSS.0b013e31820f8395
- The effect of isolated valgus moments on ACL strain during single-leg landing: a simulation study.J Biomech. 2009; 42: 280-285https://doi.org/10.1016/j.jbiomech.2008.10.031
- The effect of weightbearing and external loading on anterior cruciate ligament strain.J Biomech. 2001; 34: 163-170https://doi.org/10.1016/S0021-9290(00)00154-8
- Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study.Am J Sports Med. 2005; 33: 492-501https://doi.org/10.1177/0363546504269591
- Lower extremity biomechanics during the landing of a stop–jump task.Clin Biomech. 2006; 21: 297-305https://doi.org/10.1016/j.clinbiomech.2005.11.003
- Combined knee loading states that generate high anterior cruciate ligament forces.J Orthop Res. 1995; 13: 930-935https://doi.org/10.1002/jor.1100130618
- A quantitative analysis of valgus torque on the ACL: a human cadaveric study.J Orthop Res. 2003; 21: 1107-1112https://doi.org/10.1016/S0736-0266(03)00084-6
- Neuromuscular retraining intervention programs: do they reduce noncontact anterior cruciate ligament injury rates in adolescent female athletes?.Arthroscopy. 2014; 30: 245-255https://doi.org/10.1016/j.arthro.2013.10.009
- Neural mechanisms of selective visual attention.Annu Rev Neurosci. 1995; 18: 193-222https://doi.org/10.1146/annurev.ne.18.030195.001205
- Influence of a visuo-spatial, verbal and central executive working memory task on postural control.Gait Posture. 2001; 14: 110-116https://doi.org/10.1016/S0966-6362(01)00113-8
- Healthy older observers show equivalent perceptual–cognitive training benefits to young adults for multiple object tracking.Front Psychol. 2013; 4323https://doi.org/10.3389/fpsyg.2013.00323
- Professional athletes have extraordinary skills for rapidly learning complex and neutral dynamic visual scenes.Sci Rep. 2013; 31154https://doi.org/10.1038/srep01154
Article info
Publication history
Published online: December 22, 2018
Accepted:
October 27,
2018
Received in revised form:
October 12,
2018
Received:
February 7,
2018
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
