15 athletes who were average of 38 months post ACLR where compared to 15 matched controls. Healthy matched controls were matched on age, sex, height, mass, extremity dominance, education level, sport participation and physical activity level. All subjects filled out an IKDC (international knee documentation committee) questionnaire.
Each subject had a functional MRI performed while they performed a unilateral leg extension/flexion exercise depicted below. Each subject performed the task for 30 seconds rested 30 seconds and performed 4 blocks of movement and 5 blocks of rest. Brain activity was mapped during the course of the exercise and comparisons to matched controls were made.
ACLR patients had significantly lower scores on the IKDC when compared to matched controls. The ACLR group had increased activation in the contralateral motor cortex, contralateral lingual gyrus and ipsilateral somatosensory area. There was also diminished activation in the ipsilateral motor cortex and ipsilateral cerebellum.
What this tells us is that there is altered activation in regions of the brain that are responsible for sensory, motor and sensory-visual-spacial processing. Obviously these are key areas and proper functioning is a key part of successful return to sport performance as well as mitigating injury risk with return to sport. If you consider the two studies I spoke about last week, this may be one reason we still see these biomechanical deficits so far out from surgery despite the fact that they have had surgery. The fact that these subjects are 38 months post op, tells you that these deficits DO NOT self correct.
One perfect example is a lateral shift. As much as we think we catch it, correct it and prevent it in our ACL rehab, the reality is that there are a lot of therapist that do not. The fact that we see this in mass physicals with college athletes who had an ACLR back in high school some 3 years ago tells us we did not catch it then. The reality is, we have to do ACL rehab better. Addressing the neuroplastic changes is a perfect example.
Have you followed my instragram @bjjpt_acl_guy lately? If not, you are missing out. I am constantly posting the latest research in injury prevention and sports medicine. Don't miss out and please share with your colleagues, athletes and training partners and please be sure to follow us on instagrm @ bjjpt_acl_guy and twitter @acl_prevention. Train hard and stay well. #ViPerformAMI #ACLPlayItSafe