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The Longitudinal Neurophysiological Adaptation of a Division I Female Lacrosse Player Following Anterior Cruciate Rupture and Repair: A Case Report

BACKGROUND: Neurophysiological adaptation following anterior cruciate ligament (ACL) rupture and repair (ACLR) is critical in establishing neural pathways during the rehabilitation process. However, there is limited objective measures available to assess neurological and physiological markers of reh...

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Autores principales: Mangine, Robert, Tersak, Jim, Palmer, Thomas, Hill-Lindsay, Audrey, Patton, Bolton, Eifert-Mangine, Marsha, Jacobs, Bradley, Colosimo, Angelo J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: NASMI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10069340/
https://www.ncbi.nlm.nih.gov/pubmed/37020442
http://dx.doi.org/10.26603/001c.73179
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author Mangine, Robert
Tersak, Jim
Palmer, Thomas
Hill-Lindsay, Audrey
Patton, Bolton
Eifert-Mangine, Marsha
Jacobs, Bradley
Colosimo, Angelo J
author_facet Mangine, Robert
Tersak, Jim
Palmer, Thomas
Hill-Lindsay, Audrey
Patton, Bolton
Eifert-Mangine, Marsha
Jacobs, Bradley
Colosimo, Angelo J
author_sort Mangine, Robert
collection PubMed
description BACKGROUND: Neurophysiological adaptation following anterior cruciate ligament (ACL) rupture and repair (ACLR) is critical in establishing neural pathways during the rehabilitation process. However, there is limited objective measures available to assess neurological and physiological markers of rehabilitation. PURPOSE: To investigate the innovative use of quantitative electroencephalography (qEEG) to monitor the longitudinal change in brain and central nervous systems activity while measuring musculoskeletal function during an anterior cruciate ligament repair rehabilitation. CASE DESCRIPTION: A 19 year-old, right-handed, Division I NCAA female lacrosse midfielder suffered an anterior cruciate ligament rupture, with a tear to the posterior horn of the lateral meniscus of the right knee. Arthroscopic reconstruction utilizing a hamstring autograft and a 5% lateral meniscectomy was performed. An evidence-based ACLR rehabilitation protocol was implemented while using qEEG. OUTCOMES: Central nervous system, brain performance and musculoskeletal functional biomarkers were monitored longitudinally at three separate time points following anterior cruciate injury: twenty-four hours post ACL rupture, one month and 10 months following ACLR surgery. Biological markers of stress, recovery, brain workload, attention and physiological arousal levels yielded elevated stress determinants in the acute stages of injury and were accompanied with noted brain alterations. Brain and musculoskeletal dysfunction longitudinally reveal a neurophysiological acute compensation and recovering accommodations from time point one to three. Biological responses to stress, brain workload, arousal, attention and brain connectivity all improved over time. DISCUSSION: The neurophysiological responses following acute ACL rupture demonstrates significant dysfunction and asymmetries neurocognitively and physiologically. Initial qEEG assessments revealed hypoconnectivity and brain state dysregulation. Progressive enhanced brain efficiency and functional task progressions associated with ACLR rehabilitation had notable simultaneous improvements. There may be a role for monitoring CNS/brain state throughout rehabilitation and return to play. Future studies should investigate the use of qEEG and neurophysiological properties in tandem during the rehabilitation progression and return to play.
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spelling pubmed-100693402023-04-04 The Longitudinal Neurophysiological Adaptation of a Division I Female Lacrosse Player Following Anterior Cruciate Rupture and Repair: A Case Report Mangine, Robert Tersak, Jim Palmer, Thomas Hill-Lindsay, Audrey Patton, Bolton Eifert-Mangine, Marsha Jacobs, Bradley Colosimo, Angelo J Int J Sports Phys Ther Case Reports BACKGROUND: Neurophysiological adaptation following anterior cruciate ligament (ACL) rupture and repair (ACLR) is critical in establishing neural pathways during the rehabilitation process. However, there is limited objective measures available to assess neurological and physiological markers of rehabilitation. PURPOSE: To investigate the innovative use of quantitative electroencephalography (qEEG) to monitor the longitudinal change in brain and central nervous systems activity while measuring musculoskeletal function during an anterior cruciate ligament repair rehabilitation. CASE DESCRIPTION: A 19 year-old, right-handed, Division I NCAA female lacrosse midfielder suffered an anterior cruciate ligament rupture, with a tear to the posterior horn of the lateral meniscus of the right knee. Arthroscopic reconstruction utilizing a hamstring autograft and a 5% lateral meniscectomy was performed. An evidence-based ACLR rehabilitation protocol was implemented while using qEEG. OUTCOMES: Central nervous system, brain performance and musculoskeletal functional biomarkers were monitored longitudinally at three separate time points following anterior cruciate injury: twenty-four hours post ACL rupture, one month and 10 months following ACLR surgery. Biological markers of stress, recovery, brain workload, attention and physiological arousal levels yielded elevated stress determinants in the acute stages of injury and were accompanied with noted brain alterations. Brain and musculoskeletal dysfunction longitudinally reveal a neurophysiological acute compensation and recovering accommodations from time point one to three. Biological responses to stress, brain workload, arousal, attention and brain connectivity all improved over time. DISCUSSION: The neurophysiological responses following acute ACL rupture demonstrates significant dysfunction and asymmetries neurocognitively and physiologically. Initial qEEG assessments revealed hypoconnectivity and brain state dysregulation. Progressive enhanced brain efficiency and functional task progressions associated with ACLR rehabilitation had notable simultaneous improvements. There may be a role for monitoring CNS/brain state throughout rehabilitation and return to play. Future studies should investigate the use of qEEG and neurophysiological properties in tandem during the rehabilitation progression and return to play. NASMI 2023-04-01 /pmc/articles/PMC10069340/ /pubmed/37020442 http://dx.doi.org/10.26603/001c.73179 Text en © The Author(s) https://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (4.0) (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Case Reports
Mangine, Robert
Tersak, Jim
Palmer, Thomas
Hill-Lindsay, Audrey
Patton, Bolton
Eifert-Mangine, Marsha
Jacobs, Bradley
Colosimo, Angelo J
The Longitudinal Neurophysiological Adaptation of a Division I Female Lacrosse Player Following Anterior Cruciate Rupture and Repair: A Case Report
title The Longitudinal Neurophysiological Adaptation of a Division I Female Lacrosse Player Following Anterior Cruciate Rupture and Repair: A Case Report
title_full The Longitudinal Neurophysiological Adaptation of a Division I Female Lacrosse Player Following Anterior Cruciate Rupture and Repair: A Case Report
title_fullStr The Longitudinal Neurophysiological Adaptation of a Division I Female Lacrosse Player Following Anterior Cruciate Rupture and Repair: A Case Report
title_full_unstemmed The Longitudinal Neurophysiological Adaptation of a Division I Female Lacrosse Player Following Anterior Cruciate Rupture and Repair: A Case Report
title_short The Longitudinal Neurophysiological Adaptation of a Division I Female Lacrosse Player Following Anterior Cruciate Rupture and Repair: A Case Report
title_sort longitudinal neurophysiological adaptation of a division i female lacrosse player following anterior cruciate rupture and repair: a case report
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10069340/
https://www.ncbi.nlm.nih.gov/pubmed/37020442
http://dx.doi.org/10.26603/001c.73179
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