Objectives: The objective of this study is to examine the effect of core muscle injury, and subsequent repair, on cognitive performance as demonstrated by neurocognitive concussion tests.
Designs: This study includes 46 subjects presenting to a sports medicine institute with a diagnosis of unilateral core muscle injury established by clinical criteria and MRI. These subjects completed neurocognitive testing including Drop Stick testing and Useful Field of View (UFOV) testing. These neurocognitive tests were performed while the patient was balancing on one leg and performing a transverse abdominis contraction (TAC). Data from these tests were collected while balancing on the injured side one day pre-op, the same, now repaired side, one day post-op, and on the non-injured side both pre and post-op. Pain score during each test was recorded as well.
Results: One day pre-op, subjects were found to have a significantly faster reaction time while balancing on the non-injured side compared to the injured side (p=0.02) with no significant difference in pain (p=0.439). When comparing performance on these cognitive tests during balance on the injured side one day pre-op compared to the same side, now repaired, one day post-op, there was found to be a significant improvement in reaction time (p=0.0008) and UFOV score (p=0.027) on the newly repaired side despite a significant increase in pain (p=0.009). Lastly, no statistically significant difference in either cognitive assessment was found between sides one day post-op.
Conclusions: This suggests that mechanical impairment from a core muscle injury has a negative effect on cognition, specifically reaction time and UFOV performance, which corrects with repair of the injury. Due to the importance of normal cognitive function in athletic performance and injury prevention, it may be useful to consider cognitive impairment as a sequela of musculoskeletal injury.