Effects of Anticipation and Dual-Tasking on Lower Limb Biomechanics While Performing Change-of-Direction Tasks in Physically Active Individuals: A Systematic Review with Meta-Analysis

IF 9.4 1区 医学 Q1 SPORT SCIENCES Sports Medicine Pub Date : 2025-03-20 DOI:10.1007/s40279-025-02182-w
Clara Ebner, Urs Granacher, Dominic Gehring
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Abstract

Background

Anterior cruciate ligament (ACL) injuries are highly prevalent in team sport athletes and often occur while performing change-of-direction (COD) tasks in combination with high cognitive demands, such as decision making or divided attention. Given the expanding body of research in this field, an updated literature review is warranted, as the most recent meta-analysis on this topic included original studies published up to November 2020.

Objective

The aim of this systematic review was to examine the effects of anticipation and/or dual-tasking on lower limb biomechanics during COD tasks in healthy individuals.

Design

Systematic review with meta-analysis.

Data Sources

A systematic literature search was conducted in the electronic databases PubMed, Web of Science, CINAHL and SPORTDiscus from inception until February 2024. The included studies examined the effects of anticipation and/or dual-tasking on knee kinetics and kinematics in the frontal and sagittal planes during COD tasks.

Methods

A multilevel meta-analysis was performed to aggregate the results of studies comparing unanticipated versus anticipated CODs on lower limb biomechanics. Due to the limited available literature on dual-task versus single-task conditions, this aspect was analyzed qualitatively.

Results

The meta-analysis included 17 studies involving 355 individuals from different sports (e.g., soccer, American Football). No statistically significant differences were found between unanticipated and anticipated CODs for knee abduction and flexion moments as well as knee abduction angles (p > 0.05). Significantly higher knee flexion angles were found in unanticipated CODs (SMD = 0.74, 95% CI: 0.30–1.19; p < 0.01). Qualitative analyses of six studies including 171 individuals provided initial evidence for higher knee abduction moments and flexion angles during anticipated CODs while performing a secondary task concurrently.

Conclusion

Findings from quantitative and qualitative analyses indicate that anticipation and dual-tasking during COD performance have an impact on injury-related aspects of lower limb biomechanics. Hence, cognitive challenges should be implemented in injury risk screening and preventive strategies. Further studies with high methodological quality are needed to improve the understanding of the biomechanical and cognitive interplay in injury-threatening situations.

PROSPERO Registration Number

CRD42023433074.

Date of Registration

13.10.2023.

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预期和双重任务对运动个体在执行方向改变任务时下肢生物力学的影响:一项系统综述和荟萃分析
前交叉韧带(ACL)损伤在团队运动运动员中非常普遍,并且经常发生在执行方向改变(COD)任务时,以及高认知要求,如决策或注意力分散。鉴于该领域的研究不断扩大,有必要进行最新的文献综述,因为关于该主题的最新荟萃分析包括截至2020年11月发表的原始研究。目的本系统综述的目的是研究预期和/或双重任务对健康个体COD任务时下肢生物力学的影响。设计采用荟萃分析的系统评价。数据来源系统检索PubMed、Web of Science、CINAHL、SPORTDiscus等电子数据库自成立至2024年2月的文献。纳入的研究检查了预估和/或双重任务对COD任务中膝关节正面和矢状面动力学和运动学的影响。方法采用多水平荟萃分析,汇总比较未预期和预期CODs对下肢生物力学影响的研究结果。由于关于双任务与单任务条件的文献有限,因此对这方面进行了定性分析。结果荟萃分析包括17项研究,涉及来自不同运动(如足球,美式足球)的355人。未预期与预期的膝关节外展、屈曲力矩及膝关节外展角度的CODs差异无统计学意义(p > 0.05)。意外CODs患者膝关节屈曲角度明显增高(SMD = 0.74, 95% CI: 0.30-1.19;p < 0.01)。包括171人在内的6项研究的定性分析提供了初步证据,表明在执行次要任务的同时,在预期的CODs期间,较高的膝关节外展力矩和屈曲角度。结论定量和定性分析结果表明,预判和双重任务对下肢损伤相关方面的生物力学有影响。因此,认知挑战应该在损伤风险筛查和预防策略中实施。进一步的研究需要高质量的方法来提高对损伤威胁情况下生物力学和认知相互作用的理解。普洛斯彼罗注册号crd42023433074。注册日期:13.10.2023。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Sports Medicine
Sports Medicine 医学-运动科学
CiteScore
18.40
自引率
5.10%
发文量
165
审稿时长
6-12 weeks
期刊介绍: Sports Medicine focuses on providing definitive and comprehensive review articles that interpret and evaluate current literature, aiming to offer insights into research findings in the sports medicine and exercise field. The journal covers major topics such as sports medicine and sports science, medical syndromes associated with sport and exercise, clinical medicine's role in injury prevention and treatment, exercise for rehabilitation and health, and the application of physiological and biomechanical principles to specific sports. Types of Articles: Review Articles: Definitive and comprehensive reviews that interpret and evaluate current literature to provide rationale for and application of research findings. Leading/Current Opinion Articles: Overviews of contentious or emerging issues in the field. Original Research Articles: High-quality research articles. Enhanced Features: Additional features like slide sets, videos, and animations aimed at increasing the visibility, readership, and educational value of the journal's content. Plain Language Summaries: Summaries accompanying articles to assist readers in understanding important medical advances. Peer Review Process: All manuscripts undergo peer review by international experts to ensure quality and rigor. The journal also welcomes Letters to the Editor, which will be considered for publication.
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