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Alterations in physical and neurocognitive wellness across recovery after ACLR: A preliminary look into learned
Julie P Burland1, Adam S Lepley2, Lindsay J DiStefano1
1University of Connecticut, 2095 Hillside Road, U-1110, Storrs, CT, 06269, USA.
Objectives:
Neural alterations after anterior cruciate ligament reconstruction (ACLR) may initiate a maladaptive neurocognitive response (learned helplessness [LH]). Understanding the interrelationships between neural inhibition, quadriceps function and psychological responses can provide clinicians areas to target during recovery. The purpose was to longitudinally evaluate neural excitability, strength and self-reported LH after ACL injury and to explore the relationship between these measures and knee mechanics and patient reported function.
Design:
Case-series.
Setting:
University.
Participants:
Eight patients were evaluated across recovery after ACL injury.
Main Outcome Measures:
Neural activity, quadriceps function, and self-reported LH were evaluated at pre-surgery, 3-months post-ACLR and at the time of return to play (RTP).
Results:
Patients presented with higher helplessness between 3-months and RTP. Neural excitability and quadriceps function were variable and associated with various aspects of LH. These findings indicate a systemic inability to generate appropriate neural signaling to the quadriceps and highlights how these changes may influence perceived helplessness and overall function after ACLR.
Conclusions:
LH is related to both measures of physical function and neural outcomes and varies across recovery. This may provide clinicians with a feasible clinical tool that has the potential to identify a variety of impairments arising after ACLR.
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