认知-运动需求与基线功能对ACL损伤相关落地生物力学的影响
简介
该横断面实验室研究纳入50名健康运动员，在预期、非预期及认知挑战三种条件下完成跳跃落地任务，并记录下肢运动学与动力学数据。结果显示，基线认知运动功能与正确执行动作时的落地生物力学关联有限，但认知负荷增加可显著诱发膝外翻角增大、关节屈曲减少等ACL负荷相关的高危模式，且较低的外周视觉准确度和较高处理速度与非预期条件下任务错误率升高相关。提示评估基线认知功能及运…
英文摘要
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. STUDY DESIGN: Cross-sectional observational laboratory study. LEVEL OF EVIDENCE: Level 4. 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.