Research Article

Corticomuscular Adaptations in the Single-Leg Jump Task in Response to Progressive Mechanical Perturbation Training in Individuals With Anterior Cruciate Ligament Deficiency

Abstract

Introduction: Studies have repeatedly discussed the importance of training with sufficient cognitive and sensory-motor challenges in successfully transferring Anterior Cruciate Ligament Deficiencies (ACLDs) from rehabilitation centers to sports facilities. For this purpose, this study investigated the effect of mechanical perturbation training and standard training on the brain and muscle activity of these individuals while jumping on one leg.
Materials and Methods: A total of 30 athletes with unilateral Anterior Cruciate Ligament (ACL) rupture (in the coper classification) were randomly assigned to perturbation and standard training groups. To compare the effect of two types of intervention training methods, we examined the Similarity Index (SI) and Voluntary Response Index (VRI) in surface Electromyography (sEMG) tests of eight muscles in the lower extremities and relative power of alpha and beta spectra in Quantitative Electroencephalographic (QEEG) tests between two groups and between two limbs of each group members in the single-leg jump task.
Results: Both training groups showed improved neuromuscular control and increased SI on sEMG tests between the two limbs. However, this improvement in the perturbation training group showed an excellent increase in Effect Size (ES) (intra-group comparison values of SI for perturbation training group P=0.0001, ES=3.6; and P=0.008, ES=1.24 in the standard training group; and P=0.04, ES=0.87 in the inter-group comparison). Regarding the post-test of QEEG tests, no significant difference was found between the two groups (alpha P-value: 0.13, beta P-value: 0.07). However, in the intra-group comparison, the perturbation training group achieved excellent symmetry for the relative power spectrum of alpha and beta signals (the similarity values between the two limbs in the perturbation training group for alpha were P=0.92, ES=0.04 and for beta were P=0.92, ES=0.02; and these values for standard training group for alpha were P=0.07, ES=0.86 and for beta as P=0.08, ES=0.87).
Conclusion: The present study results showed that mechanical perturbation and standard training are suitable for transporting ACLDs to sports environments. Furthermore, in comparing these two training methods, mechanical perturbation training in the manner used in this study has higher adequacy to eliminate motor control and central nervous system defects.

1. Nawasreh Z, Logerstedt D, Failla M, Snyder-Mackler L. No difference between mechanical perturbation training with compliant surface and manual perturbation training on knee functional performance after ACL rupture. J Orthop Res. 2018;36(5):1391–7.
2. Fashkhami AN, Rahimi A, Kalantari KK. The voluntary response index in electromyographic study during landing test of the patients with ACL deficiency: A new study protocol. Iran Red Crescent Med J. 2014;16(5).
3. Ageberg E, Björkman A, Rosén B, Lundborg G, Roos EM. Principles of brain plasticity in improving sensorimotor function of the knee and leg in healthy subjects: A double-blind randomized exploratory trial. BMC Musculoskelet Disord. 2009;10(1).
4. S J, S T, Mousavi M V, B H, Hazaveh SH S. Changes in the Trend of Walking Motor Control in Athletes with Anterior Cruciate Ligament Deficiency in Response to Progressive Perturbation Trainings. Austin Sport Med. 2021;6(1):1–9.
5. Yim JH, Seon JK, Kim YK, Jung ST, Shin CS, Yang DH, et al. Anterior translation and rotational stability of anterior cruciate ligament-deficient knees during walking: speed and turning direction. J Orthop Sci. 2015;20(1):155–62.
6. Kapreli E, Athanasopoulos S. The anterior cruciate ligament deficiency as a model of brain plasticity. Med Hypotheses. 2006;67(3):645–50.
7. Hartigan E, Axe MJ, Snyder-Mackler L. Perturbation training prior to ACL reconstruction improves gait asymmetries in non-copers. J Orthop Res. 2009;27(6):724–9.
8. Nawasreh Z, Failla M, Marmon A, Logerstedt D, Snyder-Mackler L. Comparing the effects of mechanical perturbation training with a compliant surface and manual perturbation training on joints kinematics after ACL-rupture. Gait Posture. 2018;64(March):43–9.
9. Neto T, Sayer T, Theisen D, Mierau A. Functional brain plasticity associated with ACL injury: A scoping review of current evidence. Neural Plast. 2019;2019.
10. Nawasreh ZH, Marmon AR, Logerstedt D, Snyder-Mackler L. the Effect of Training on a Compliant Surface on Muscle Activation and Co-Contraction After Anterior Cruciate Ligament Injury. Int J Sports Phys Ther. 2019;14(4):3554–63.
11. Hart JM, Ko JWK, Konold T, Pietrosimione B. Sagittal plane knee joint moments following anterior cruciate ligament injury and reconstruction: A systematic review. Clin Biomech. 2010;25(4):277–83.
12. Slater L V., Hart JM, Kelly AR, Kuenze CM. Progressive changes in walking kinematics and kinetics after anterior cruciate ligament injury and reconstruction: A review and meta-Analysis. J Athl Train. 2017;52(9):847–60.
13. Chmielewski TL, Hurd WJ, Rudolph KS, Axe MJ, Snyder-mackler L. Kinematics and Reduces Muscle. Phys Ther. 2005;85(8):740–54.
14. Needle AR, Lepley AS, Grooms DR. Central Nervous System Adaptation After Ligamentous Injury: a Summary of Theories, Evidence, and Clinical Interpretation. Sport Med. 2017;47(7):1271–88.
15. Grooms D, Appelbaum G, Onate J. Neuroplasticity following anterior cruciate ligament injury: A framework for visual-motor training approaches in rehabilitation. J Orthop Sports Phys Ther. 2015;45(5):381–93.
16. Grooms DR, Page SJ, Onate JA. Brain activation for knee movement measured days before second anterior cruciate ligament injury: Neuroimaging in musculoskeletal medicine. J Athl Train. 2015;50(10):1005–10.
17. Okuda K, Abe N, Katayama Y, Senda M, Kuroda T, Inoue H. Effect of vision on postural sway in anterior cruciate ligament injured knees. J Orthop Sci. 2005;10(3):277–83.
18. Negahban H, Ahmadi P, Salehi R, Mehravar M, Goharpey S. Attentional demands of postural control during single leg stance in patients with anterior cruciate ligament reconstruction. Neurosci Lett. 2013;556:118–23.
19. McLean SG, Lipfert SW, Van Den Bogert AJ. Effect of gender and defensive opponent on the biomechanics of sidestep cutting. Med Sci Sports Exerc. 2004;36(6):1008–16.
20. Moksnes, Håvard, Snyder-Mackler, Lynn, Risberg MA. Individuals With an ACL-deficient Knee Classified as Noncopers May be Candidates for Nonsurgical Rehabilitation. 2010;38(10):586–95.
21. Gokeler A, Bisschop M, Myer GD, Benjaminse A, Dijkstra PU, van Keeken HG, et al. Immersive virtual reality improves movement patterns in patients after ACL reconstruction: implications for enhanced criteria-based return-to-sport rehabilitation. Knee Surgery, Sport Traumatol Arthrosc. 2016;24(7):2280–6.
22. Letafatkar A, Rajabi R, Minoonejad H, Rabiei P. Efficacy of Perturbation-Enhanced Neuromuscular Training on Hamstring and Quadriceps Onset Time, Activation and Knee Flexion During a Tuck-Jump Task. Int J Sports Phys Ther. 2019;14(2):214–27.
23. Fitzgerald GK, Axe M, Snyder-mackler L. on Operative. Phys Ther. 2000;30(4):194–203.
24. Mohapatra S, Krishnan V, Aruin AS. Postural control in response to an external perturbation: Effect of altered proprioceptive information. Exp Brain Res. 2012;217(2):197–208.
25. Gokeler A, Seil R, Kerkhoffs G, Verhagen E. A novel approach to enhance ACL injury prevention programs. J Exp Orthop. 2018;5(1):0–5.
26. Fitzgerald GK, Axe MJ, Snyder-Mackler L. The efficacy of perturbation training in nonoperative anterior cruciate ligament rehabilitation programs for physically active individuals. Phys Ther. 2000;80(2):128–51.
27. Wager MGT and JFS. 基因的改变NIH Public Access. Bone. 2011;23(1):1–7.
28. Shumway-Cook A., MH. W. Motor learning. 3rd editio. Lippincott William and Wilkins; 2007.
29. Howard JS, Fazio MA, Mattacola CG, Uhl TL, Jacobs CA. Structure, sex, and strength and knee and hip kinematics during landing. J Athl Train. 2011;46(4):376–85.
30. Padua DA, Marshall SW, Boling MC, Thigpen CA, Garrett WE, Beutler AI. The Landing Error Scoring System (LESS) is a valid and reliable clinical assessment tool of jump-landing biomechanics: The jump-ACL Study. Am J Sports Med. 2009;37(10):1996–2002.
31. Ross SE, Guskiewicz KM, Yu B. Single-Leg Jump-Landing Stabilization Unstable Ankles. 2005;(October).
32. Lee DC, Lim HK, McKay WB, Priebe MM, Holmes SA, Sherwood AM. Toward an objective interpretation of surface EMG patterns: A voluntary response index (VRI). J Electromyogr Kinesiol. 2004;14(3):379–88.
33. Wang H, Kwag JS, Jung M. Review of EMG indexes for quantifying the total muscle activity. 2004;
34. Hyun KL, Lee DC, McKay WB, Protas EJ, Holmes SA, Priebe MM, et al. Analysis of sEMG during voluntary movement - Part II: Voluntary response index sensitivity. IEEE Trans Neural Syst Rehabil Eng. 2004;12(4):416–21.
35. McLeod SA. What does effect size tell you? Simply psycology. 2019.
36. Diermeier T, Rothrauff BB, Engebretsen L, Lynch AD, Ayeni OR, Paterno M V., et al. Treatment After Anterior Cruciate Ligament Injury: Panther Symposium ACL Treatment Consensus Group. Orthop J Sport Med. 2020;8(6):1–12.
37. Koga H, Nakamae A, Shima Y, Iwasa J, Myklebust G, Engebretsen L, et al. Mechanisms for noncontact anterior cruciate ligament injuries: Knee joint kinematics in 10 injury situations from female team handball and basketball. Am J Sports Med. 2010;38(11):2218–25.
38. Mierau A, Hülsdünker T, Strüder HK. Changes in cortical activity associated with adaptive behavior during repeated balance perturbation of unpredictable timing. Front Behav Neurosci. 2015;9(OCT):1–12.
39. Zhang Z, Gao Y, Wang J. Effects of vision and cognitive load on anticipatory and compensatory postural control. Hum Mov Sci. 2019;64(148):398–408.
40. Ovechkin A, Vitaz T, de Paleville DT, Aslan S, McKay W. Evaluation of respiratory muscle activation in individuals with chronic spinal cord injury. Respir Physiol Neurobiol. 2010;173(2):171–8.
41. Lin J jenq, Lim HK, Soto-quijano DA, Hanten WP, Olson SL, Roddey TS, et al. Altered patterns of muscle activation during performance of four functional tasks in patients with shoulder disorders: Interpretation from voluntary response index. J Electromyogr Kinesiol. 2006;16(5):458–68.
42. Neeter C, Gustavsson A, Thomeé P, Augustsson J, Thomeé R, Karlsson J. Development of a strength test battery for evaluating leg muscle power after anterior cruciate ligament injury and reconstruction. Knee Surgery, Sport Traumatol Arthrosc. 2006;14(6):571–80.
43. Gustavsson A, Neeter C, Thomeé P, Grävare Silbernagel K, Augustsson J, Thomeé R, et al. A test battery for evaluating hop performance in patients with an ACL injury and patients who have undergone ACL reconstruction. Knee Surgery, Sport Traumatol Arthrosc. 2006;14(8):778–88.
44. Theisen D, Rada I, Brau A, Gette P, Seil R. Muscle activity onset prior to landing in patients after anterior cruciate ligament injury: A systematic review and meta-analysis. PLoS One. 2016;11(5):1–17.
45. Miao X, Huang H, Hu X, Li D, Yu Y, Ao Y. The characteristics of EEG power spectra changes after ACL rupture. PLoS One. 2017;12(2):1–19.
46. Schmied A, Forget R, Vedel JP. Motor unit firing pattern, synchrony and coherence in a deafferented patient. Front Hum Neurosci. 2014;8(OCT):1–16.
47. Baumeister J, Reinecke K, Weiss M. Changed cortical activity after anterior cruciate ligament reconstruction in a joint position paradigm: An EEG study. Scand J Med Sci Sport. 2008;18(4):473–84.
48. Baumeister J, Reinecke K, Schubert M, Weiß M. Altered electrocortical brain activity after ACL reconstruction during force control. J Orthop Res. 2011;29(9):1383–9.
49. Gokeler A, Neuhaus D, Benjaminse A, Grooms DR, Baumeister J. Principles of Motor Learning to Support Neuroplasticity After ACL Injury: Implications for Optimizing Performance and Reducing Risk of Second ACL Injury. Sport Med. 2019;49(6):853–65.
50. Gola M, Magnuski M, Szumska I, Wróbel A. EEG beta band activity is related to attention and attentional deficits in the visual performance of elderly subjects. Int J Psychophysiol. 2013;89(3):334–41.
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IssueVol 16 No 1 (2022) QRcode
SectionResearch Article(s)
DOI https://doi.org/10.18502/jmr.v16i1.483
Keywords
Anterior Cruciate Ligament Deficiency (ACLD) Perturbation training Single-leg jumping task Surface Electromyography (sEMG) Quantitative Electroencephalographic (QEEG)

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Jomhouri S, Talebian S, Vaez Mousavi M, Hatef B, Sadjadi-Hazaveh SH. Corticomuscular Adaptations in the Single-Leg Jump Task in Response to Progressive Mechanical Perturbation Training in Individuals With Anterior Cruciate Ligament Deficiency. jmr. 2022;16(1):89-104.