The Influence of Cognitive Dual Tasking on the Outcomes of the Triple Hop Test Following Anterior Cruciate Ligament Reconstruction.

Abstract

Introduction: Anterior cruciate ligament (ACL) reconstruction involves prolonged rehabilitation, with Return to Sport (RTS) as a key goal for athletes. Integrating Dual Task (DT) strategies, which combine cognitive and physical tasks, is critical, as multitasking mirrors real-world and sports-specific demands. Assessing how distractions affect performance is essential to optimize RTS outcomes for both the reconstructed and healthy limbs.

Purpose: To analyze the influence of DT on the performance of the Triple Hop Test for distance (THD) in individuals' status post ACL reconstruction.

Study type: Cross Sectional.

Materials and methods: Seventeen patients post-ACL were recruited and performed THD under two conditions: single task (standard condition) and dual task (with an added neurocognitive task). Assessments were conducted on both the healthy and the previously injured limb over six meters, measured via a standard measuring tape. Paired t-tests and Mann-Whitney-Wilcoxon or Kruskal-Wallis tests were applied to investigate differences. Categorical variables were compared using chi-squared tests.

Results: There was a significant difference in average distance between single task performances in the healthy and previously operated limbs, with a difference of 20.71 cm (p=0.016). A significant difference was also observed in DT performance, with a distance variation of 10.41 cm (p=0.038). Comparing performances, both the healthy and the ACL-reconstructed limbs showed performance deterioration under DT conditions, with a greater percentage decline in the healthy limb.

Conclusions: Dual Task conditions appear to hinder performance in the THD in both the healthy and post-ACL reconstructed limbs.

Level of evidence: 3b.