BACKGROUND: Neurocognitive demands during sport-specific tasks may influence movement patterns associated with anterior cruciate ligament (ACL) injury risk, but the effect of baseline cognitive-motor function remains unclear. This study investigated whether baseline cognitive-motor performance is associated with ACL injury-related biomechanics during landing tasks with increasing cognitive demands.
HYPOTHESES: (1) People with lower baseline cognitive scores would exhibit riskier movement patterns, and (2) cognitive load would negatively influence ACL-related biomechanics.
METHODS: A total of 50 healthy athletes completed baseline cognitive-motor testing for reaction time (872 ± 90 ms), processing speed (83 ± 14%), divided attention (58 ± 14%), and peripheral vision (69 ± 12%), followed by a jump-land-jump task under anticipated (ANT), unanticipated (UNA), and cognitively-challenging (COG) conditions involving peripheral vision. Peak lower-limb kinematics and kinetics were recorded, and mixed-effects models were used to evaluate the effects of cognitive-motor load and baseline function on biomechanical outcomes.
RESULTS: Baseline cognitive-motor performance showed limited associations with landing biomechanics during valid trials, with isolated relationships observed for hip flexion and adduction angles (P = 0.05 and P = 0.04, respectively). Lower peripheral vision accuracy (P < 0.001) and higher processing speed (P < 0.001) were significantly associated with a greater incidence of errors during nonanticipated conditions (error rates: ANT 0%, UNA 2.8%, COG 35.5%). Increasing cognitive load consistently induced biomechanical changes associated with greater ACL loading markers (P = 0.02 to <0.004), including increased knee abduction angles and moments and reduced joint flexion, with significant differences between ANT and both UNA and COG conditions.
CONCLUSION: While baseline cognitive-motor function may have a limited influence on correctly executed movement biomechanics in healthy athletes, specific cognitive domains are related to task execution errors under cognitively demanding conditions, notably including higher processing speed. Increased cognitive-motor demands involving unanticipation and peripheral vision systematically altered landing mechanics toward potentially higher-risk patterns.
CLINICAL RELEVANCE: Assessing baseline cognitive-motor function and sport-specific demands may help inform ACL injury risk screening strategies. Failed trials represent an additional dimension to be considered for investigating the influence of cognitive factors on ACL injury biomechanics.
STUDY DESIGN: Cross-sectional observational laboratory study.
LEVEL OF EVIDENCE: Level 4.
Read the article: PubMed · Publisher (DOI)