Integrated 3D motion analysis with functional magnetic resonance neuroimaging to identify neural correlates of lower extremity movement

Anand, Manish; Diekfuss, Jed A.; Slutsky‐Ganesh, Alexis B.; Grooms, Dustin R.; Bonnette, Scott; Foss, Kim D. Barber; DiCesare, Christopher A.; Hunnicutt, Jennifer L.; Myer, Gregory D.

doi:10.1016/j.jneumeth.2021.109108

Cited by 12 publications

(14 citation statements)

References 67 publications

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“…Future studies might consider inserting this evaluation in a real-world scenario. Indeed, recent studies on neuromuscular control in ACL-injured patients argued that neurocognitive alterations might happen during the situational patterns leading to an ACL injury [ 2 , 9 , 10 ]. Therefore, the introduction of additional focuses could help to discriminate between safe and unsafe return to the field.…”

Section: Discussionmentioning

confidence: 99%

A 2D qualitative movement assessment of a deceleration task detects football players with high knee joint loading

Paolo

Zaffagnini

Tosarelli³

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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Purpose The deceleration (pressing) is a common situational pattern leading to anterior cruciate ligament (ACL) injury in football. Although mainly assessed for performance purposes, a stronger focus on movement quality might support the screening of at-risk athletes. The aim of the present study was to describe a 2D scoring system for the assessment of the deceleration task and to associate it with the knee joint loading (knee abduction moment) evaluated through the gold standard 3D motion capture. The hypothesis was that lower 2D scores would be associated with higher knee joint loading. Methods Thirty-four competitive football (soccer) players (age 22.8 ± 4.1, 16 females) performed a series of deceleration tasks. 3D motion analysis was recorded using ten stereophotogrammetric cameras, a force platform, and three high-speed cameras. The 2D qualitative assessment was performed via a scoring system based on the video analysis of frontal and lateral planes joint kinematics for five scoring criteria. The intra- and inter-rater reliabilities were calculated for each 2D scoring criteria. The peak knee abduction moment was extracted and grouped according to the results of the 2D evaluation. Results An ICC > 0.94 was found for all the 2D scoring criteria, both for intra-rater and inter-rater reliability. The players with low 2D frontal plane scores and low total scores (0–4) showed significantly higher peak knee abduction moment values (p < 0.001). A significant negative rank correlation was found between the total score and the peak knee abduction moment (ρ = − 0.25, p < 0.001). Conclusions The qualitative 2D scoring system described successfully discerned between athletes with high and low knee joint loading during a deceleration task. The application of this qualitative movement assessment based on a detailed and accurate scoring system is suitable to identify players and patients with high knee joint loading (high knee abduction moments) and target additional training in the scenario of the primary and secondary ACL injury risk reduction. Level of evidence Level IV.

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Section: Discussionmentioning

confidence: 99%

A 2D qualitative movement assessment of a deceleration task detects football players with high knee joint loading

Paolo

Zaffagnini

Tosarelli³

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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“…This investigation employed a leg press neuroimaging paradigm to examine brain activity for bilateral motor control. We adapted a unilateral version of this paradigm [ 33 ], specifically one with good to excellent intersession reliability over a ~seven week period [ 34 ], for bilateral lower extremity movement. Participant landing mechanics were also assessed during a drop vertical jump using traditional 3D motion analysis (separate from the neuroimaging paradigm).…”

Section: Methodsmentioning

confidence: 99%

Preliminary brain-behavioral neural correlates of anterior cruciate ligament injury risk landing biomechanics using a novel bilateral leg press neuroimaging paradigm

et al. 2022

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Anterior cruciate ligament (ACL) injury risk reduction strategies primarily focus on biomechanical factors related to frontal plane knee motion and loading. Although central nervous system processing has emerged as a contributor to injury risk, brain activity associated with the resultant ACL injury-risk biomechanics is limited. Thus, the purposes of this preliminary study were to determine the relationship between bilateral motor control brain activity and injury risk biomechanics and isolate differences in brain activity for those who demonstrate high versus low ACL injury risk. Thirty-one high school female athletes completed a novel, multi-joint leg press during brain functional magnetic resonance imaging (fMRI) to characterize bilateral motor control brain activity. Athletes also completed an established biomechanical assessment of ACL injury risk biomechanics within a 3D motion analysis laboratory. Knee abduction moments during landing were modelled as a covariate of interest within the fMRI analyses to identify directional relationships with brain activity and an injury-risk group classification analysis, based on established knee abduction moment cut-points. Greater landing knee abduction moments were associated with greater lingual gyrus, intracalcarine cortex, posterior cingulate cortex and precuneus activity when performing the bilateral leg press (all z > 3.1, p < .05; multiple comparison corrected). In the follow-up injury-risk classification analysis, those classified as high ACL injury-risk had greater activity in the lingual gyrus, parietal cortex and bilateral primary and secondary motor cortices relative to those classified as low ACL injury-risk (all z > 3.1, p < .05; multiple comparison corrected). In young female athletes, elevated brain activity for bilateral leg motor control in regions that integrate sensory, spatial, and attentional information were related to ACL injury-risk landing biomechanics. These data implicate crossmodal visual and proprioceptive integration brain activity and knee spatial awareness as potential neurotherapeutic targets to optimize ACL injury-risk reduction strategies.

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“…The multi-joint leg press task consisted of a combined unilateral ankle-knee-hip extension-flexion movement under load. 16 For this task, participants laid supine on the MRI table in a leg-press testing apparatus made up of two pedals on a track (allowing for both sides to be set-up for movement, but the left and right sides were completed independently). Participant restraints were similar to the knee motor task but with the ankle braces removed and the task completed by having the participant flex a single knee to ~45° of flexion (with concurrent hip and ankle flexion) with the feet moving along the track and then extending that knee to approximately 0° of flexion with the resistance of ~20% of their body weight via resistance bands.…”

Section: Multi-joint Leg Press Against Resistance (Ankle-knee-hip Ext...mentioning

confidence: 99%

“…15 In addition to the added multi-joint requirements and resistance likely increasing motor output (motor cortex) demand, the restricted range of motion due to the foot pedal tracks may reduce probability to detect sensory processing changes relative to the isolated knee task (which found several sensory integration regions to increase in activity post aNMT). 16 Sensorimotor cortex efficiency (i.e. decreased neural activity) response from aNMT to control the ankle-knee-hip under load may support an improved neuromuscular capability not directly linked to pKAM during landing (as it was not correlated with pKAM changes).…”

Section: Trainingmentioning

confidence: 99%

Preliminary Report on the Train the Brain Project, Part II: Neuroplasticity of Augmented Neuromuscular Training and Improved Injury-Risk Biomechanics

Grooms

Diekfuss

Slutsky‐Ganesh

et al. 2022

Journal of Athletic Training

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Context: Neuromuscular training (NMT) facilitates the acquisition of new movement patterns that reduce ACL injury risk; however, the neural mechanisms underlying these changes are unknown. Objective: Determine the relationship between brain activation and biomechanical changes following NMT with biofeedback. Study Design: Controlled Laboratory Study Setting: Research laboratory Participants: Final analyses included twenty high school female soccer athletes (15.7±0.95 years; 1.68±0.05 m; 59.91±5.62 kg). Main Outcome Measures: Ten participants completed 6 weeks of NMT augmented with real-time biofeedback (aNMT) to reduce knee injury risk movements, and 10 participants completed no training. aNMT was implemented with visual biofeedback that responded in real-time to injury-risk biomechanical variables. A drop vertical jump with 3D motion capture was used to assess injury risk neuromuscular changes before and after the six-week intervention. Pre to post brain activation changes were measured using functional magnetic resonance imaging (fMRI) during unilateral knee and multi-joint motor tasks. Results: Following aNMT, sensory (precuneus), visual-spatial (lingual gyrus), and motor planning (pre-motor) brain activity increased for knee specific movement and sensorimotor cortex activity for multi-joint movement decreased. Knee abduction moment during landing also decreased (4.66±5.45 Nm; p=0.02; g=0.82) in the aNMT group with no change in the control group (p>0.05). The training-induced increased brain activity for isolated knee movement was associated with decreases in knee abduction moment (r=.67, p=.036) and sensorimotor cortex activity for multi-joint movement (r=.87, p=.001). No significant change in brain activity was observed in the control group (p>0.05). Conclusions: The relationship between neural changes observed across tasks and reduced knee abduction suggests that aNMT facilitates recruitment of sensory integration centers to support reduced injury risk mechanics and improve sensorimotor neural efficiency for multi-joint control. Further research is warranted to determine if this training related multimodal neuroplasticity enhances neuromuscular control during more complex sport-specific activities.

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Integrated 3D motion analysis with functional magnetic resonance neuroimaging to identify neural correlates of lower extremity movement

Cited by 12 publications

References 67 publications

A 2D qualitative movement assessment of a deceleration task detects football players with high knee joint loading

A 2D qualitative movement assessment of a deceleration task detects football players with high knee joint loading

Preliminary brain-behavioral neural correlates of anterior cruciate ligament injury risk landing biomechanics using a novel bilateral leg press neuroimaging paradigm

Preliminary Report on the Train the Brain Project, Part II: Neuroplasticity of Augmented Neuromuscular Training and Improved Injury-Risk Biomechanics

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