Impact of neurocognitive function on sex and limb dominance during an unanticipated sidestep cut

An unanticipated sidestep cut is a game-realistic movement used in cutting sports that has been identified as one of the movements linked to non-contact anterior cruciate ligament injuries. Factors such as limb dominance and sex have been observed to increase susceptibility of injury, but reasons behind the findings remain unclear. Aspects of unanticipated sidestep cutting may be influenced by neurocognitive processing speeds, thus the purpose of the current study was to assess the influence of neurocognitive performance (NCRT) on lower extremity biomechanics during an unanticipated sidestep cut and determine if NCRT performance helps elucidate the interactions between sex and limb dominance previously observed. Repeated measures ANOVAs and repeated measures ANCOVAs were performed to analyze the biomechanical differences of a cut with and without NCRT as a covariate. Twenty-one participants (n=11 males) volunteered to participate in the study (age: 22.4 ± 2.9 years, height: 1.71 ± .082m, mass: 72.2 ± 12.8). Participants completed various reaction time tasks and five unanticipated sidestep cuts on each limb. When adjusting for NCRT performance, significant limb differences in hip extension moment (p=.027) were revealed, with additional significant sex x NCRT differences in hip flexion moment (p=0.003) and trunk lean to the plant leg (p=0.004). Significant effects for approach speed (p=.043) and knee extension moment (p=.041) were unmasked by neurocognitive performance. The results demonstrated evidence of differences based on neurocognitive performance impacting biomechanical measures related to injury risk during unanticipated sidestep cutting. The exploratory study revealed potential risk factors associated with ACL injury that were unmasked or confounded by NCRT performance which were previously attributed to either sex or limb dominance differences. Neurocognition is an influential aspect of unanticipated cutting mechanics and additional research is needed to better understand and help the prevention of non-contact ACL injuries.