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Brain retraining could improve recovery after ACL injury

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A new study could help athletes regain full function after an anterior cruciate ligament (ACL) injury.

Researchers at the Ohio State University Wexner Medical Center found that full recovery from ACL injury is more than just physical — it requires retraining the brain.

The study, published in the Journal of Orthopaedic & Sports Physical Therapy, showed that parts of the brain associated with leg movement lagged during recovery from an ACL injury.

“The brain fundamentally changed in how it processes information from an injured knee,” explained Dustin Grooms, a researcher who conducted the study at Ohio State. “We think those changes play a big role in why people who recover from ACL injuries don´t trust their knees entirely and tend to move them differently.”

The research team compared brain scans, revealing differences in brain activity in healthy adults, versus those recovering from ACL injuries, when extending and flexing the knee.

Instead of relying on movement or spatial awareness, people who had suffered an ACL injury relied more on their visual systems in the brain when moving their knee and didn´t move it as naturally or instinctively as those who had not been injured, the university said.

“It´s like walking in the dark, you don´t walk as fast, you don´t move as confidently,” commented Jimmy Onate, a health and rehabilitative sciences researcher at Ohio State Wexner Medical Center. “These individuals may, in a smaller sense, be doing the same thing — not moving as confidently and constantly using visual feedback from the world around them when they really don´t need to.”

Consistently depending on the brain´s visual systems for movement can cause complications when participating in complex sports, according to the researchers. One solution is to use strobe glasses to include motor learning and visual-motor compensations in rehabilitation.

“The idea is to use these glasses to visually distract these patients, so their brains will rewire back to their original state,” said Grooms. “That will allow them to once again move their knee based on natural instinct instead of relying on visual cues.”