Restricted access

Purchase article

USD $24.95

Student 1 year subscription

USD $74.00

1 year subscription

USD $99.00

Student 2 year subscription

USD $141.00

2 year subscription

USD $185.00

Context: A limiting factor for reducing anterior cruciate ligament injury risk is ensuring that the movement adaptions made during the prevention program transfer to sport-specific activity. Virtual reality provides a mechanism to assess transferability, and neuroimaging provides a means to assay the neural processes allowing for such skill transfer. Objective: To determine the neural mechanisms for injury risk–reducing biomechanics transfer to sport after anterior cruciate ligament injury prevention training. Design: Cohort study. Setting: Research laboratory. Participants: Four healthy high school soccer athletes. Interventions: Participants completed augmented neuromuscular training utilizing real-time visual feedback. An unloaded knee extension task and a loaded leg press task were completed with neuroimaging before and after training. A virtual reality soccer-specific landing task was also competed following training to assess transfer of movement mechanics. Main Outcome Measures: Landing mechanics during the virtual reality soccer task and blood oxygen level–dependent signal change during neuroimaging. Results: Increased motor planning, sensory and visual region activity during unloaded knee extension and decreased motor cortex activity during loaded leg press were highly correlated with improvements in landing mechanics (decreased hip adduction and knee rotation). Conclusion: Changes in brain activity may underlie adaptation and transfer of injury risk–reducing movement mechanics to sport activity. Clinicians may be able to target these specific brain processes with adjunctive therapy to facilitate intervention improvements transferring to sport.

Grooms is with Ohio Musculoskeletal & Neurological Institute, Ohio University, Athens, OH, USA; and the Division of Athletic Training, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens, OH, USA. Kiefer, Ellis, Thomas, Kitchen, DiCesare, Bonnette, Gadd, Barber Foss, Galloway, Diekfuss, Berz, and Myer are with The SPORT Center, Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA. Kiefer, Ellis, Yuan, and Myer are with the University of Cincinnati College of Medicine, Cincinnati, OH, USA. Kiefer, Riley, and Silva are with the Center for Cognition, Action, & Perception, Department of Psychology, University of Cincinnati, Cincinnati, OH. Yuan is with Pediatric Neuroimaging Research Consortium, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA. Galloway is also with Duke University School of Medicine, Durham, NC. Leach is with the Division of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA. Myer is with the Department of Pediatrics and Orthopaedic Surgery, University of Cincinnati, Cincinnati, OH, USA; the Micheli Center for Sports Injury Prevention, Waltham, MA, USA; and the Department of Orthopaedics, University of Pennsylvania, Philadelphia, PA, USA.

Grooms (groomsd@ohio.edu) is corresponding author.
Journal of Sport Rehabilitation
Article Sections
References
  • 1.

    Sugimoto DMyer GDBarber Foss KDHewett TE. Specific exercise effects of preventive neuromuscular training intervention on anterior cruciate ligament injury risk reduction in young females: meta-analysis and subgroup analysis. Br J Sports Med. 2015;49(5):282289. PubMed ID: 25452612 doi:10.1136/bjsports-2014-093461

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Kiefer AWMyer GD. Training the antifragile athlete: a preliminary analysis of neuromuscular training effects on muscle activation dynamics. Nonlinear Dynamics Psychol Life Sci. 2015;19(4):489510. PubMed ID: 26375937

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Myer GDStroube BWDiCesare CAet al. Augmented feedback supports skill transfer and reduces high-risk injury landing mechanics: a double-blind, randomized controlled laboratory study. Am J Sports Med. 2013;41(3):669677. PubMed ID: 23371471 doi:10.1177/0363546512472977

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Kristianslund EKrosshaug T. Comparison of drop jumps and sport-specific sidestep cutting: implications for anterior cruciate ligament injury risk screening. Am J Sports Med. 2013;41(3):684688. PubMed ID: 23287439 doi:10.1177/0363546512472043

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Chaudhari AMHearn BKAndriacchi TP. Sport-dependent variations in arm position during single-limb landing influence knee loading: implications for anterior cruciate ligament injury. Am J Sports Med. 2005;33(6):824830. PubMed ID: 15827366 doi:10.1177/0363546504270455

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Kiefer AWDiCesare CBonnette Set al. Sport-specific virtual reality to identify profiles of anterior cruciate ligament injury risk curing unanticipated cutting. Paper presented at: International Conference on Virtual Rehabilitation; 2017. Montreal, CD.

    • Export Citation
  • 7.

    Rose FDAttree EABrooks BMParslow DMPenn PRAmbihaipahan N. Training in virtual environments: transfer to real world tasks and equivalence to real task training. Ergonomics. 2000;43(4):494511. PubMed ID: 10801083 doi:10.1080/001401300184378

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Powers CMFisher B. Mechanisms underlying ACL injury-prevention training: the brain-behavior relationship. J Athl Train. 2010;45(5):513515. PubMed ID: 20831400 doi:10.4085/1062-6050-45.5.513

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Seidler RDNoll DC. Neuroanatomical correlates of motor acquisition and motor transfer. J Neurophysiol. 2008;99(4):18361845. PubMed ID: 18272874 doi:10.1152/jn.01187.2007

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Myer GDPaterno MVFord KRHewett TE. Neuromuscular training techniques to target deficits before return to sport after anterior cruciate ligament reconstruction. J Strength Cond Res. 2008;22(3):9871014. PubMed ID: 18438211 doi:10.1519/JSC.0b013e31816a86cd

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Hewett TEFord KRXu YYKhoury JMyer GD. Effectiveness of neuromuscular training based on the neuromuscular risk profile. Am J Sports Med. 2017;45(9):21422147. PubMed ID: 28441059 doi:10.1177/0363546517700128

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Grooms DRPage SJNichols-Larsen DSChaudhair AMWhite SEOnate JA. Neuroplasticity associated with anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther. 2017;47(3):180189. PubMed ID: 27817301 doi:10.2519/jospt.2017.7003

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Grooms DRPage SJOnate JA. Brain activation for knee movement measured days before second anterior cruciate ligament injury: neuroimaging in musculoskeletal medicine. J Athl Train. 2015;50(10):10051010. PubMed ID: 26509775 doi:10.4085/1062-6050-50.10.02

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Del Percio CBabiloni CMarzano Net al. “Neural efficiency” of athletes’ brain for upright standing: a high-resolution EEG study. Brain Res Bull. 2009;79(3–4):193200. PubMed ID: 19429191 doi:10.1016/j.brainresbull.2009.02.001

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Picard NMatsuzaka YStrick PL. Extended practice of a motor skill is associated with reduced metabolic activity in M1. Nat Neurosci. 2013;16(9):13401347. PubMed ID: 23912947 doi:10.1038/nn.3477

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Dunst BBenedek MJauk Eet al. Neural efficiency as a function of task demands. Intelligence. 2014;42(100):2230. PubMed ID: 24489416 doi:10.1016/j.intell.2013.09.005

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Wulf GLewthwaite R. Optimizing performance through intrinsic motivation and attention for learning: the OPTIMAL theory of motor learning. Psychon Bull Rev. 2016;23(5):13821414. PubMed ID: 26833314 doi:10.3758/s13423-015-0999-9

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Gokeler ABenjaminse AHewett TEet al. Feedback techniques to target functional deficits following anterior cruciate ligament reconstruction: implications for motor control and reduction of second injury risk. Sports Med. 2013;43(11):10651074. PubMed ID: 24062274 doi:10.1007/s40279-013-0095-0

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Kim K-MKim J-SGrooms DR. Stroboscopic vision to induce sensory reweighting during postural control. J Sport Rehabil. 2017;12:111. PubMed ID: 28605310 doi:10.1123/jsr.2017-0035

    • Search Google Scholar
    • Export Citation
Article Metrics
All Time Past Year Past 30 Days
Abstract Views 213 213 58
Full Text Views 26 26 3
PDF Downloads 14 14 1
Altmetric Badge
PubMed
Google Scholar
Cited By