ABSTRACT
Prospective evidence indicates that functional biomechanics and brain connectivity may predispose an athlete to an anterior cruciate ligament injury, revealing novel neural linkages for targeted neuromuscular training interventions. The purpose of this study was to determine the efficacy of a real-time biofeedback system for altering knee biomechanics and brain functional connectivity. Seventeen healthy, young, physically active female athletes completed 6 weeks of augmented neuromuscular training (aNMT) utilizing real-time, interactive visual biofeedback and 13 served as untrained controls. A drop vertical jump and resting state functional magnetic resonance imaging were separately completed at pre- and posttest time points to assess sensorimotor adaptation. The aNMT group had a significant reduction in peak knee abduction moment (pKAM) compared to controls (p = .03, d = 0.71). The aNMT group also exhibited a significant increase in functional connectivity between the right supplementary motor area and the left thalamus (p = .0473 after false discovery rate correction). Greater percent change in pKAM was also related to increased connectivity between the right cerebellum and right thalamus for the aNMT group (p = .0292 after false discovery rate correction, r2 = .62). No significant changes were observed for the controls (ps > .05). Our data provide preliminary evidence of potential neural mechanisms for aNMT-induced motor adaptations that reduce injury risk. Future research is warranted to understand the role of neuromuscular training alone and how each component of aNMT influences biomechanics and functional connectivity.
Subject(s)
Adaptation, Physiological/physiology , Anterior Cruciate Ligament Injuries/prevention & control , Biofeedback, Psychology/physiology , Biomechanical Phenomena/physiology , Cerebellum/physiology , Connectome , Knee/physiology , Nerve Net/physiology , Practice, Psychological , Psychomotor Performance/physiology , Sensorimotor Cortex/physiology , Thalamus/physiology , Adolescent , Biofeedback, Psychology/methods , Cerebellum/diagnostic imaging , Female , Humans , Longitudinal Studies , Magnetic Resonance Imaging , Nerve Net/diagnostic imaging , Sensorimotor Cortex/diagnostic imaging , Thalamus/diagnostic imagingABSTRACT
CONTEXT: Biofeedback training enables an athlete to alter biomechanical and physiological function by receiving biomechanical and physiological data concurrent with or immediately after a task. OBJECTIVE: To compare the effects of 2 different modes of real-time biofeedback focused on reducing risk factors related to anterior cruciate ligament injury. DESIGN: Randomized crossover study design. SETTING: Biomechanics laboratory and sports medicine center. PARTICIPANTS: Female high school soccer players (age 14.8 ± 1.0 y, height 162.6 ± 6.8 cm, mass 55.9 ± 7.0 kg; n = 4). INTERVENTION: A battery of kinetic- or kinematic-based real-time biofeedback during repetitive double-leg squats. MAIN OUTCOME MEASURES: Baseline and posttraining drop vertical jumps were collected to determine if either feedback method improved high injury risk landing mechanics. RESULTS: Maximum knee abduction moment and angle during the landing was significantly decreased after kinetic-focused biofeedback (P = .04). The reduced knee abduction moment during the drop vertical jumps after kinematic-focused biofeedback was not different (P = .2). Maximum knee abduction angle was significantly decreased after kinetic biofeedback (P < .01) but only showed a trend toward reduction after kinematic biofeedback (P = .08). CONCLUSIONS: The innovative biofeedback employed in the current study reduced knee abduction load and posture from baseline to posttraining during a drop vertical jump.