Neuromusculoskeletal Alterations After ACL Injury

Duzce University60 enrolled

Overview

This study investigated how anterior cruciate ligament (ACL) injuries affect not only the knee joint but also brain activity, reaction speed, and psychological readiness to return to sports. A total of 60 male athletes, aged 18 to 30 years, were evaluated in three groups: healthy athletes, athletes who had undergone primary ACL reconstruction, and athletes who had undergone revision ACL reconstruction. The study measured brain activity with electroencephalography (EEG), reaction time with a computer-based test, and psychological status with standardized questionnaires. The findings showed that athletes with revision ACL surgery had more difficulties in attention control, slower reaction times, and greater psychological barriers compared to the other groups. These results suggest that ACL injuries and surgeries may influence not only physical recovery but also brain function and psychological readiness. The study highlights the importance of considering neuromuscular, cognitive, and emotional aspects when planning rehabilitation and return-to-sport decisions.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Anterior Cruciate Ligament Injuries Sports Injury Neurocognitive Function

Eligibility

Sex: MALEMin age: 18 YearsMax age: 30 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: Male athletes Age between 18 and 30 years Regular participation in amateur or professional sports Completion of ACL rehabilitation (for surgical groups) at least 6 months before enrollment Ability to undergo EEG and reaction time testing Provision of signed informed consent Exclusion Criteria: History of neurological or psychiatric conditions (e.g., epilepsy, ADHD, depression) Additional lower extremity injuries or orthopedic surgeries Metal implants or scalp conditions incompatible with EEG Uncorrected visual or auditory deficits Systemic illnesses (e.g., diabetes, multiple sclerosis, neuropathy) Use of psychoactive medication Any cognitive or physical limitation interfering with testing procedures Female participants (to avoid hormonal confounding effects on EEG recordings)

Outcomes

Primary Outcomes

Frontal EEG Theta/Beta Ratio

Cortical activity measured at F3 and F4 electrode sites using EEG (Nexus-10 system, Mind Media, Netherlands). Theta (4-8 Hz) and beta (13-21 Hz) power spectral densities were calculated and the ratio (theta/beta) was used as an indicator of attentional control. Higher ratios indicate reduced attention and cognitive efficiency.

Time frame: Single assessment on the study day (June-July 2025)

Secondary Outcomes

Visual Reaction Time (ms)

Computer-based visual response task; mean reaction time (ms) computed across 5 valid trials after practice. Longer times indicate lower sensorimotor efficiency.

Time frame: Single assessment on the study day (June-July 2025)

Kinesiophobia (TSK-11 total score)

Tampa Scale of Kinesiophobia-11; 11 items, 1-4 Likert; total score 11-44. Higher scores indicate greater fear of movement/reinjury.

Time frame: Single assessment on the study day (June-July 2025)

Psychological Readiness to Return to Sport (ACL-RSI total score)

ACL-RSI questionnaire; 12 items scored 0-100; total reported as mean (0-100). Higher scores indicate greater psychological readiness.

Time frame: Single assessment on the study day (June-July 2025)

Neuromusculoskeletal Alterations After ACL Injury

Overview

Conditions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes