Baseline cognitive performance moderates ACL injury-related knee biomechanics during unanticipated sidestep cutting in highly trained male soccer players.

OBJECTIVE: To compare anterior cruciate ligament (ACL) injury-related knee biomechanics between anticipated and unanticipated sidestep cutting and to investigate whether baseline cognitive performance moderated these biomechanical responses in highly trained male soccer players. METHODS: Thirty highly trained male soccer players completed a computerized Go/No-Go task to assess inhibitory control, including reaction time (RT), commission error rate (CER; responses incorrectly made during No-Go trials), and omission error rate (OER; failures to respond during Go trials). Participants subsequently performed anticipated and unanticipated 90° sidestep cutting tasks while three-dimensional motion capture and force plate data were simultaneously collected. Peak knee flexion angle, peak knee abduction angle, peak knee abduction moment, peak anterior tibial shear force (ATSF), peak vertical ground reaction force (vGRF), and loading rate were analyzed. Paired comparisons were first performed to examine overall biomechanical differences between the anticipated and unanticipated conditions. Linear mixed-effects models were then used to investigate whether cognitive performance moderated the biomechanical responses to task anticipation. RESULTS: Compared with the anticipated condition, unanticipated sidestep cutting resulted in greater peak knee flexion angle (d = 0.389, 95% CI, 0.118-0.660, p = 0.006), peak knee abduction angle (d = 0.339, 95% CI, 0.189-0.489, p < 0.001), and peak knee abduction moment (d = 1.481, 95% CI, 0.857-2.104, p < 0.001). Significant anticipation × RT interactions were observed for peak knee abduction angle (β std = 0.156, 95% CI, 0.039-0.274, p = 0.031), peak knee abduction moment (β std = 0.380, 95% CI, 0.168-0.592, p < 0.001), and peak ATSF (β std = 0.517, 95% CI, 0.350-0.684, p < 0.001). Significant anticipation × CER and anticipation × OER interactions were observed for peak knee abduction moment (β std = 0.504, 95% CI, 0.299-0.710, p < 0.001) and peak vGRF (β std = 0.463, 95% CI, 0.245-0.682, p < 0.001), respectively. CONCLUSION: Unanticipated sidestep cutting altered multiple ACL injury-related biomechanical variables in highly trained male soccer players. More importantly, athletes' baseline cognitive performance moderated several ACL injury-related biomechanical responses.