Neuroscience Principles for ACL Rehabilitation and Reinjury Risk Reduction

Oñate, James A.; Herman, Daniel C.; Grooms, Dustin R.; Sutton, Zach; Wilkerson, Gary B.

doi:10.1007/978-3-030-22361-8_16

Cited by 7 publications

(7 citation statements)

References 229 publications

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“…Moreover, high activations involving parieto-occipital cortical areas associated with spatial cognition and orientation, as well as visual-motor processing, have been found linked to motor control during functional motor tasks [ 32 , 68 ]. Unfortunately, sensorimotor control of the injured lower extremity may appear to rely on visual information processing and cortical motor planning [ 89 ]. This, in turn, may limit the individual’s capacity to manage complex motor situations and subsequently predispose ACLR patients to recurrent injury after their return-to-sports [ 83 , 98 ].…”

Section: Consider Neurophysiological Effects Of Acl Injury Ii: Neurop...mentioning

confidence: 99%

Return to sports after ACL injury 5 years from now: 10 things we must do

et al. 2022

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Background The outcome after ACL reconstruction (ACLR) is in general disappointing with unacceptable number of athletes that do not return to pre-injury level of sports, high re-injury rates, early development of osteoarthritis and shorter careers. Athletes after ACLR have high expectation to return to sports which is in contrast with the current outcomes. The aim of this manuscript is to present an overview of factors that are needed to be incorporated and to personalize the rehabilitation process for an athlete who has undergone an ACLR. Level of evidence 4.

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Section: Consider Neurophysiological Effects Of Acl Injury Ii: Neurop...mentioning

confidence: 99%

Return to sports after ACL injury 5 years from now: 10 things we must do

et al. 2022

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“…Additionally, the present findings revealed that higher functional connectivity within the alpha-2 frequency band particularly appeared in the contralateral hemisphere to the injured standing leg of patients after ACLR. As proprioception and motor control of distal limbs is majorly ascribed to the contralateral cortical hemisphere (Shumway-Cook and Woollacott, 2012), it may be supposed that patients after ACLR require enhanced information processing to coordinate efferent neural signaling to maintain knee joint stability when standing on their injured limb (Pietrosimone et al, 2015;Grooms et al, 2017;Onate et al, 2019;Criss et al, 2020;Lepley et al, 2020). In fact, the current investigation demonstrated significantly different characteristics of occipito-motor and parieto-motor functional connections in ACLR.…”

Section: Discussionmentioning

confidence: 61%

“…Thus, higher functional connectivity of parieto-occipital and motor connections may point to stronger functional relationships and interactions between these related areas (Rubinov and Sporns, 2010). Based on this rationale, higher functional connectivity incorporating the somatosensory and visual areas may therefore serve as a compensatory mechanism to cope with the decreased responsiveness of motor areas in patients after ACLR (Onate et al, 2019;Criss et al, 2020;Lepley et al, 2020). Consequently, these elevated cortical contributions to maintain postural equilibrium could substantially affect more complex sensorimotor tasks, giving priority to postural stability at the expense of accuracy and speed of accompanying motor or cognitive actions (Mohammadi-Rad et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Functional Cortical Connectivity Related to Postural Control in Patients Six Weeks After Anterior Cruciate Ligament Reconstruction

Lehmann

Büchel

Mouton

et al. 2021

Front. Hum. Neurosci.

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Whereas initial findings have already identified cortical patterns accompanying proprioceptive deficiencies in patients after anterior cruciate ligament reconstruction (ACLR), little is known about compensatory sensorimotor mechanisms for re-establishing postural control. Therefore, the aim of the present study was to explore leg dependent patterns of cortical contributions to postural control in patients 6 weeks following ACLR. A total of 12 patients after ACLR (25.1 ± 3.2 years, 178.1 ± 9.7 cm, 77.5 ± 14.4 kg) and another 12 gender, age, and activity matched healthy controls participated in this study. All subjects performed 10 × 30 s. single leg stances on each leg, equipped with 64-channel mobile electroencephalography (EEG). Postural stability was quantified by area of sway and sway velocity. Estimations of the weighted phase lag index were conducted as a cortical measure of functional connectivity. The findings showed significant group × leg interactions for increased functional connectivity in the anterior cruciate ligament (ACL) injured leg, predominantly including fronto−parietal [F(1, 22) = 8.41, p ≤ 0.008, η2 = 0.28], fronto−occipital [F(1, 22) = 4.43, p ≤ 0.047, η2 = 0.17], parieto−motor [F(1, 22) = 10.30, p ≤ 0.004, η2 = 0.32], occipito−motor [F(1, 22) = 5.21, p ≤ 0.032, η2 = 0.19], and occipito−parietal [F(1, 22) = 4.60, p ≤ 0.043, η2 = 0.17] intra−hemispherical connections in the contralateral hemisphere and occipito−motor [F(1, 22) = 7.33, p ≤ 0.013, η2 = 0.25] on the ipsilateral hemisphere to the injured leg. Higher functional connectivity in patients after ACLR, attained by increased emphasis of functional connections incorporating the somatosensory and visual areas, may serve as a compensatory mechanism to control postural stability of the injured leg in the early phase of rehabilitation. These preliminary results may help to develop new neurophysiological assessments for detecting functional deficiencies after ACLR in the future.

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“…The proposed consequence of the Piezo2 channelopathy is the “mis-wiring” phenomenon often mentioned in the scientific literature in reference to chemotherapy and non-contact injuries. Onate depicted a similar phenomenon after anterior cruciate ligament reconstruction using the analogy that an inappropriately fixed electrical cord cannot conduct electricity in the prior manner [ 50 ]. Mendelsohn demonstrated that the loss of proprioceptor activity due to transmission block did not reduce the proprioceptor input into the spinal cord; however, antagonist muscle innervation was avoided [ 51 ].…”

Section: Miswiring Due To Piezo2 Channelopathymentioning

confidence: 99%

Miswired Proprioception in Amyotrophic Lateral Sclerosis in Relation to Pain Sensation (and in Delayed Onset Muscle Soreness)—Is Piezo2 Channelopathy a Principal Transcription Activator in Proprioceptive Terminals Besides Being the Potential Primary Damage?

Sonkodi

2023

Life

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Amyotrophic lateral sclerosis (ALS) is a lethal neurodegenerative multisystem disease, with an unknown pathomechanism, resulting in progressive motoneuron loss. In 90–95% of cases, ALS is sporadic, but close to 10% of ALS is familial with inherited gene mutations from family members. Recently, a non-contact dying-back injury mechanism theory of ALS postulated that irreversible intrafusal proprioceptive terminal degeneration induces the non-resolving progressive impairment of the proprioceptive circuitry, leading to motoneuron loss, progressive overloading and depletion of the central nervous system, and eventually to death. The current manuscript proposes that irreversible Piezo2 channelopathy of this proprioceptive terminal degeneration induces constantly activated and dysregulated transcription process in ALS, providing access to underlying pathogenic gene variants and letting the cell-type-specific noncoding DNA mutations become more apparent. This opinion piece proposes that ALS genes are associated with the Piezo2 channelopathy mechanism both downstream and upstream, and their mutations, along with the aging process, could explain the non-contact dying-back injury mechanism theory of ALS. Moreover, irreversible microinjury of the Piezo2 ion channel could be the primary damage or the root cause of death in ALS. Finally, the current manuscript also depicts the pathomechanism as to why ALS is considered a painless disease.

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Neuroscience Principles for ACL Rehabilitation and Reinjury Risk Reduction

Cited by 7 publications

References 229 publications

Return to sports after ACL injury 5 years from now: 10 things we must do

Return to sports after ACL injury 5 years from now: 10 things we must do

Functional Cortical Connectivity Related to Postural Control in Patients Six Weeks After Anterior Cruciate Ligament Reconstruction

Miswired Proprioception in Amyotrophic Lateral Sclerosis in Relation to Pain Sensation (and in Delayed Onset Muscle Soreness)—Is Piezo2 Channelopathy a Principal Transcription Activator in Proprioceptive Terminals Besides Being the Potential Primary Damage?

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