Mental Fatigue Uniquely Influences Drop Landing Biomechanics for Individuals With a Concussion History

in Journal of Sport Rehabilitation

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Eric J. ShumskiDepartment of Kinesiology, California State University—Fullerton, Fullerton, CA, USA
UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens, GA, USA

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Tricia M. KasamatsuDepartment of Kinesiology, California State University—Fullerton, Fullerton, CA, USA

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Kathleen S. WilsonDepartment of Kinesiology, California State University—Fullerton, Fullerton, CA, USA

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Derek N. PamukoffSchool of Kinesiology, Western University, London, ON, Canada

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DOI:
https://doi.org/10.1123/jsr.2022-0252
Keywords:
cognitive fatigue; injury risk; lower-extremity; mild traumatic brain injury; vertical loading rate
First Published Online:
30 Jan 2023
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Ahead of Print
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1–8
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Context: Induced mental fatigue negatively impacts sport performance and neurocognition. However, it is unclear how induced mental fatigue influences landing biomechanics. The purpose of this study was to examine the influence of mental fatigue on drop landing biomechanics in individuals with and without a concussion history. Design: Crossover design. Methods: Forty-eight (24 per group) recreationally active individuals were matched on age (±3 y), sex, and body mass index (±1 kg/m2). All participants completed an experimental (30-min Stroop task) and control (30-min reading magazines) intervention on separate days separated by a minimum of 24 hours. Drop landings were performed before and after both interventions. Outcomes included peak vertical ground reaction force (vGRF), vertical loading rate (VLR), knee flexion angle, knee abduction angle, external knee flexion moment, external knee abduction moment, and initial ground contact knee flexion and knee abduction angles. Separate 2 (group) × 2 (intervention) between-within analyses of covariance compared drop landing outcomes. Each group’s average pre-Stroop and premagazine outcomes were covariates. Results: There was a significant interaction for vGRF (P = .033, ηp2=.097) and VLR (P = .0497, ηp2=.083). The vGRF simple effects were not statistically significantly (P range = .052–.325). However, individuals with a concussion history displayed a medium effect size for greater vGRF post-Stroop compared with their own postmagazine vGRF (mean difference (95% confidence interval [95% CI] = 0.163 (–0.002 to 0.327) bodyweight (BW), p = .052, ηp2=.081. In contrast, the control group displayed a small effect size (mean difference [95% CI] = 0.095 [–0.069 to 0.259] BW, p = .251, ηp2=.029). Individuals with a concussion history displayed greater VLR post-Stroop compared with controls (mean difference [95% CI], 26.29 [6.19 to 46.40] BW/s, P = .012, ηp2=.134) and their own postmagazine values (mean difference [95% CI] = 32.61 [7.80 to 57.42] BW/s, p = .011, ηp2=.135). Conclusion: Mental fatigue leads to greater VLR for individuals with a concussion history. Athletic competition and activities of daily living can increase mental fatigue. Training programs may seek to teach mental fatigue reducing strategies to athletes with a concussion history.

Supplementary Materials

    • Supplementary Figure S1 (pdf 66 KB)
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    • Supplementary Table S2 (pdf 56 KB)
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