Proprioception and Central Nervous Excitability: Implications for Return-to-Play in Athletes with Ligament or Meniscal Injuries.
Yumi Okayama, Shinichi Daikuya
PMID 40756788WHAT IT FOUND
Athletes with prior knee injuries showed higher central nervous system excitability when using visual feedback to maintain knee torque.
This suggests visual cues may override proprioceptive control, potentially hindering the automatic movement patterns needed for safe return to sport.
Key findings
01In athletes with a history of knee injury, the amplitude ratio of long-latency reflexes (LLR/Mmax) was significantly higher during visual feedback conditions compared to verbal feedback conditions.
02Uninjured knees showed significantly higher median frequency of torque curve (indicating finer adjustment) during visual feedback compared to verbal feedback, whereas injured knees did not show this significant difference.
03The single athlete who had not returned to competition beyond the scheduled time exhibited increased median frequency of torque curve and decreased LLR/Mmax amplitude ratio, indicating suboptimal fine muscle adjustments.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Small sample size (n=21 total, n=6 in injured group). Heterogeneity in injury types (ACL, MCL, meniscal, etc.) and time since injury. Only female participants; results may not generalize to males. Could not analyze differences between dominant and non-dominant limbs due to sample size. LLR measured from the thumb, not the leg, inferring central excitability indirectly.
Declared interests
No specific conflicts of interest or funding sources were declared in the provided text.
The easy way to misread this
Do not conclude that visual feedback is universally beneficial for all injured athletes. In the injured group, visual feedback was associated with higher central nervous system excitability, which the authors suggest might inhibit the automation of movement needed for return to sport. This finding contrasts with uninjured knees, where visual feedback improved torque adjustment.