# Establishing Cognitive-Motor Function as a Missing Therapeutic Target after Anterior Cruciate Ligament Reconstruction

> **NIH NIH R03** · MONTANA STATE UNIVERSITY - BOZEMAN · 2022 · $143,213

## Abstract

The spectrum of cognitive-motor impairments following anterior cruciate ligament reconstruction (ACLR) is
poorly defined. This knowledge gap is an important problem because recent evidence indicates that the
current dependence on isolated motor tests for ACLR clinical decision making is insufficient to ensure restored
function in complex sports environments or prevent a second injury. Under existing tests, the interaction
between cognition and motor control is routinely missed and deficits are allowed to remain despite passing
discharge criteria. Mounting evidence demonstrates that the interaction of cognitive and motor function is
impaired after musculoskeletal injury, including ACL tears. There is a critical need for studies that establish
the scope and severity of cognitive-motor impairments in ACLR patients to provide novel therapeutic targets.
The long-term goal of this research is to improve ACLR rehabilitation outcomes. The objective of this R03 is
to demonstrate the spectrum of cognitive-motor impairments with rigorous lab-based metrics following ACLR.
Clinical translation will be achieved by validating cost-effective and simple tests for cognitive-motor
performance against lab-based measures. The central hypotheses are that 1) simultaneous cognitive tasks
will reveal neuromuscular impairments following ACLR, 2) clinical surrogate tests will be related to lab-based
metrics, and 3) worse cognitive-motor impairments will predict poorer patient-reported outcomes of knee
function and psychological factors. The study objective will be achieved through two specific aims: 1) elucidate
the spectrum of dual-task impairments that persist following ACLR, and 2) demonstrate the clinical relevance
of dual-task impairments following ACLR. For the first aim, 3D biomechanical analyses will be done for
jumping tasks with an innovative approach of systematically adding simultaneous cognitive tasks (i.e., dual
tasks) that target specific cognitive processes (e.g., decision making). Clinical cognitive-motor dual-task tests
will also be validated. Greater increases in frontal plane knee motion (ACL injury risk factor) when visually-
demanding cognitive tasks are added will support the primary hypothesis for the first aim. Strong correlations
between dual-task impairments in clinic-based tests and dual-task impairments in frontal plane knee motion
from lab-based tests will support the second hypothesis. Greater dual-task impairments on lab-based tests
associating with worse patient-reported outcomes of knee function and psychological factors will support the
hypothesis of the second aim. The approach is innovative because it will systematically introduce different
types of cognitive challenges designed around the neurophysiological changes associated with ACL injury
that go unquantified in current treatment. The research is significant because it will identify novel therapeutic
targets for ACLR rehabilitation by determining the most salient cognitive-motor imp...

## Key facts

- **NIH application ID:** 10301013
- **Project number:** 5R03HD101093-02
- **Recipient organization:** MONTANA STATE UNIVERSITY - BOZEMAN
- **Principal Investigator:** Scott M. Monfort
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $143,213
- **Award type:** 5
- **Project period:** 2020-12-01 → 2024-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10301013

## Citation

> US National Institutes of Health, RePORTER application 10301013, Establishing Cognitive-Motor Function as a Missing Therapeutic Target after Anterior Cruciate Ligament Reconstruction (5R03HD101093-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10301013. Licensed CC0.

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