Neurocognitive demands reduce jump distance and coordination variability of the injured leg in athletes after anterior cruciate ligament reconstruction

<jats:title>Abstract</jats:title><jats:sec><jats:title>Purpose</jats:title><jats:p>The study aimed to evaluate the impact of neurocognitive reliance on jump distance and lower extremity kinematics in individuals who had undergone anterior cruciate ligament reconstruction (ACLR). This was achieved by comparing hop performance under standard and neurocognitive conditions.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Thirty‐two patients after ACLR and 32 healthy controls (CTRL) participated. Both groups performed a single‐leg hop for distance (SLHD) and two neurocognitive hop tests, each designed to evaluate distinct aspects of neurocognition. The neurocognitive tests included the reaction SLHD (R‐SLHD), measuring reaction to a central stimulus and working memory SLHD (WM‐SLHD) assessing response to a memorized stimulus amidst distractor stimuli. Distances were assessed for the three‐hop tests. In addition, joint kinematics were collected to calculate lower extremity coordination of the lower extremity. SLHD performance was defined as the mean hop distance per condition per leg for each participant and was analyzed using a mixed ANOVA with condition and leg as the within‐subjects factors and the group (ACLR or CTRL) as the between‐subjects factor. Differences in joint coordination variability were analyzed using two‐sample <jats:italic>t</jats:italic>‐test statistical parametric mapping (SPM) with linear regression.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The WM‐SLHD resulted in a significantly decreased jump distance compared with the standard hop test both for ACLR and CTRL. Furthermore, the leg difference within the ACLR group increased under higher cognitive load as tested with the WM‐SLHD, indicating leg‐specific adaptations in lower extremity coordination.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Neurocognitive single‐leg hop tests resulted in reduced jump distance in CTRL and ACLR. The neurocognitive hop test revealed changes in coordination variability for the CTRL and the uninjured leg of ACLR individuals, whereas the injured leg's coordination variability remained unaltered, suggesting persistent cognitive control of movements post‐ACLR.</jats:p></jats:sec><jats:sec><jats:title>Level of Evidence</jats:title><jats:p>Level III.</jats:p></jats:sec>