A Preliminary Investigation into the Neural Correlates of Knee Loading during a Change of Direction Task in Individuals after Anterior Cruciate Ligament Reconstruction.
Adam Culiver, Dustin Grooms, Nathan Edwards and 2 others
PMID 36793571WHAT IT FOUND
Eight people with ACL reconstruction showed slightly lower knee extension moments when vision was disrupted, but this change was smaller than the minimal detectable difference.
Brain activity in visual-sensory areas correlated with knee loading only during the disrupted vision condition.
Key findings
01Peak internal knee extension moment was statistically lower in the stroboscopic vision condition compared to full vision, but the difference was between the minimum detectable change and the minimal clinically important difference.
02There was a significant positive correlation between peak internal knee extension moment in the stroboscopic condition and BOLD signal in the contralateral precuneus and superior parietal lobe.
03No significant associations were found between brain activity during basic knee movement and any biomechanical variables during the full vision condition.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The sample size was extremely small (n=8), limiting the ability to draw definitive conclusions. Participants were at a wide range of time points post-surgery (12 to 108 months), which may have influenced results due to varying levels of adaptation. There was no control group (healthy individuals), so it is unclear if the observed brain activity or biomechanics are beneficial or negative adaptations. The study was correlational, so it cannot establish that brain activity causes the changes in knee loading. Attentional demands and visual memory were not measured, even though the stroboscopic goggles likely increased these factors, which could have influenced the results. The primary biomechanical finding (lower knee extension moment) was statistically significant but likely not clinically meaningful, as it was smaller than the minimal clinically important difference.
Declared interests
All authors report no relevant financial disclosures to the submitted work.
The easy way to misread this
Do not interpret the statistically significant reduction in knee extension moment during stroboscopic vision as a clinically meaningful change. The difference (0.104 N*m/kg) was smaller than the minimal clinically important difference (0.12 N*m/kg), and the study's small sample size and correlational design prevent any causal conclusions about brain activity and movement.