Abstract
Context:
Individuals who undergo anterior cruciate ligament (ACL) reconstruction (ACLR) have altered sensorimotor brain activity that can persist for years. Directing an individual's focus of attention (FoA) using instructional cues during rehabilitation and motor control training can impact movement performance but the direct effects on sensorimotor brain activity and network level relationships in an ACLR population are less understood. This can have important implications for understanding the neural underpinnings of automatic control processes for direct application to motor learning.
Objective:
Determine differences in brain activity and patterns of activity when ACLR knee movement is cued using an internal FoA (iFoA) compared to an external FoA(eFoA).
Design:
Cross-sectional study.
Setting:
Research labarotary.
Patients or Other Participants:
We recruited 12 participants (7 females, 6.9 ± 1.0 weeks post- ACLR) after primary, unilateral, ACLR. Participants performed repeated isometric quadriceps contractions under iFoA and eFoA conditions during functional magnetic resonance imaging scans.
Main Outcome Measures:
Brain activity (blood oxygen level dependent response) from anatomic regions of interest were extracted from move-rest contrasts in each FoA condition and paired t-tests determined differences in activity across conditions. Intra and inter-network connectivity analyses were performed using MELODIC ICA. Dual regression and fsl randomise were used to determine differences in network connectivity between iFoA and eFoA conditions.
Results:
The eFoA condition elicited greater activity in precuneus compared to the iFoA condition. Default Mode Network (DMN) demonstrated greater intra-network connectivity in the eFoA condition compared to iFoA in precuneus and lateral occipital cortex.
Conclusion:
Increased precuneus activity may be a favorable adaptation for motor performance and greater within DMN connectivity could indicate more optimal network organization to improve motor efficiency and support automation. This suggests that automatic control processes may be facilitated neurologically by eFoA, reducing the attentional demand to perform basic knee movement after ACLR.
Individuals who undergo anterior cruciate ligament (ACL) reconstruction (ACLR) have altered sensorimotor brain activity that can persist for years. Directing an individual's focus of attention (FoA) using instructional cues during rehabilitation and motor control training can impact movement performance but the direct effects on sensorimotor brain activity and network level relationships in an ACLR population are less understood. This can have important implications for understanding the neural underpinnings of automatic control processes for direct application to motor learning.
Objective:
Determine differences in brain activity and patterns of activity when ACLR knee movement is cued using an internal FoA (iFoA) compared to an external FoA(eFoA).
Design:
Cross-sectional study.
Setting:
Research labarotary.
Patients or Other Participants:
We recruited 12 participants (7 females, 6.9 ± 1.0 weeks post- ACLR) after primary, unilateral, ACLR. Participants performed repeated isometric quadriceps contractions under iFoA and eFoA conditions during functional magnetic resonance imaging scans.
Main Outcome Measures:
Brain activity (blood oxygen level dependent response) from anatomic regions of interest were extracted from move-rest contrasts in each FoA condition and paired t-tests determined differences in activity across conditions. Intra and inter-network connectivity analyses were performed using MELODIC ICA. Dual regression and fsl randomise were used to determine differences in network connectivity between iFoA and eFoA conditions.
Results:
The eFoA condition elicited greater activity in precuneus compared to the iFoA condition. Default Mode Network (DMN) demonstrated greater intra-network connectivity in the eFoA condition compared to iFoA in precuneus and lateral occipital cortex.
Conclusion:
Increased precuneus activity may be a favorable adaptation for motor performance and greater within DMN connectivity could indicate more optimal network organization to improve motor efficiency and support automation. This suggests that automatic control processes may be facilitated neurologically by eFoA, reducing the attentional demand to perform basic knee movement after ACLR.
| Original language | English |
|---|---|
| Pages (from-to) | 837-844 |
| Number of pages | 8 |
| Journal | Journal of Athletic Training |
| Volume | 60 |
| Issue number | 12 |
| Early online date | 18 Aug 2025 |
| DOIs | |
| Publication status | Published - 23 Dec 2025 |
Keywords
- functional magnetic resonance imaging (fMRI)
- motor control
- sensorimotor