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Unimpaired performance during cognitive and visual manipulations in persons with anterior cruciate ligament reconstruction compared to healthy adults

Psychology of Sport and Exercise(2022)

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Abstract
Emerging research has proposed an increased reliance on visual processing and cognitive faculties in persons following anterior cruciate ligament reconstruction (ACLR). ACLR individuals display increased activation of visual and cognitive processing brain areas during task execution and exhibit dramatic performance decrements when vision is removed or cognitive difficulty is increased. Despite these intriguing findings, no previous studies have comprehensively assessed performance-related outcomes during tasks that challenge the cognitive and visual systems in ACLR individuals. The following hypotheses were proposed: 1) ACLR individuals will perform better on cognitive tests that required visual scanning; 2) ACLR individuals will utilize visual biofeedback when available during a proprioceptive task but experience decrements in performance when visual biofeedback is removed; and 3) during a cognitive-motor dual-task, the motor task will be more attentionally demanding for ACLR individuals compared to controls, whereas cognitive dual-task effects will be similar between groups. Twenty-one individuals with ACLR and 21 matched healthy adults performed a series of cognitive tests (Stroop, Trail Making Test, and NIH EXAMINER Battery), as well as a single-task angle-matching paradigm with and without visual biofeedback and a dual-task angle-matching paradigm with varying levels of visual and cognitive difficulty. ACLR individuals performed similarly on cognitive tasks, regardless of visual scanning requirements, demonstrated similar proprioceptive performance, evident via similar drift during the single-task conditions, and exhibited similar dual-task effects when the angle-matching paradigm was performed concurrently with a cognitive test compared to healthy adults. Despite a growing literature suggesting alterations to visual and cognitive system utilization in ACLR individuals, the current investigation found a subset of ACLR individuals do not exhibit this performance.
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Key words
Dual-task effects,Cognition,Vision,Proprioception,ACLR
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