{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T17:46:33Z","timestamp":1778953593848,"version":"3.51.4"},"reference-count":30,"publisher":"National Athletic Trainers' Association","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,12,1]]},"abstract":"<jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Fear of reinjury after an anterior cruciate ligament (ACL) reconstruction (ACLR) may be associated with persistent deficits in knee function and subsequent injury. However, the effects of negative emotion on neuromuscular-control strategies after an ACL injury have remained unclear.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To identify how negative emotional stimuli affect neural processing in the brain and muscle coordination in patients after anterior cruciate ligament reconstruction compared with healthy control participants.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Case-control study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Neuromechanics laboratory.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients or Other Participants<\/jats:title>\n                  <jats:p>Twenty patients after unilateral anterior cruciate ligament reconstruction and 20 healthy recruits.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measure(s)<\/jats:title>\n                  <jats:p>Electrocortical \u03b8 (4\u20138 Hz) activity (event-related synchronization, % increased power relative to a nonactive baseline) at selected electrodes placed at the frontal (F3, Fz, F4) and parietal (P3, Pz, P4) cortices using electroencephalography, neurophysiological cardiac changes (beats\/min), and subjective fear perceptions were measured, along with joint stiffness (Nm\/\u00b0\/kg) with and without an acoustic stimulus in response to 3 types of emotionally evocative images (neutral, fearful, and knee-injury pictures).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Both groups had greater frontoparietal \u03b8 power with fearful pictures (Fz: 35.9% \u00b1 29.4%; Pz: 81.4% \u00b1 66.8%) than neutral pictures (Fz: 24.8% \u00b1 29.7%, P = .002; Pz: 64.2 \u00b1 54.7%, P = .024). The control group had greater heart-rate deceleration with fearful (\u22124.6 \u00b1 1.4 beats\/min) than neutral (\u22123.6 \u00b1 1.3 beats\/min, P &amp;lt; .001) pictures, whereas the ACLR group exhibited decreased heart rates with both the fearful (\u22124.6 \u00b1 1.3 beats\/min) and injury-related (\u22124.4 \u00b1 1.5 beats\/min) pictures compared with neutral pictures (\u22123.4 \u00b1 1.4 beats\/min, P &amp;lt; .001). Furthermore, during the acoustic startle condition, fearful pictures increased joint stiffness (Nm\/\u00b0\/kg) in the ACLR group at the midrange (0\u00b0\u201320\u00b0: 0.027 \u00b1 0.02) and long range (0\u00b0\u201340\u00b0: 0.050 \u00b1 0.02) compared with the neutral pictures (0\u00b0\u201320\u00b0: 0.017 \u00b1 0.01, P = .024; 0\u00b0\u201340\u00b0: 0.043 \u00b1 0.02, P = .014).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Negative visual stimuli simultaneously altered neural processing in the frontoparietal cortices and joint-stiffness regulation strategies in response to a sudden perturbation. The adverse effects of fear on neuromuscular control may indicate that psychological interventions should be incorporated in neuromuscular-control exercise programs after ACL injury.<\/jats:p>\n               <\/jats:sec>","DOI":"10.4085\/1062-6050-246-18","type":"journal-article","created":{"date-parts":[[2019,9,25]],"date-time":"2019-09-25T16:48:57Z","timestamp":1569430137000},"page":"1269-1279","source":"Crossref","is-referenced-by-count":15,"title":["Negative Emotion and Joint-Stiffness Regulation Strategies After Anterior Cruciate Ligament Injury"],"prefix":"10.4085","volume":"54","author":[{"given":"Yong Woo","family":"An","sequence":"first","affiliation":[{"name":"Department of Kinesiology and Dance, New Mexico State University, Las Cruces"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea DiTrani","family":"Lobacz","sequence":"first","affiliation":[{"name":"Department of Athletic Training, Neumann University, Aston, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jochen","family":"Baumeister","sequence":"first","affiliation":[{"name":"Department of Sports and Health, Institute of Sport Medicine, Paderborn University, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William C.","family":"Rose","sequence":"first","affiliation":[{"name":"Departments of Kinesiology and Applied Physiology, University of Delaware, Newark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jill S.","family":"Higginson","sequence":"first","affiliation":[{"name":"Mechanical Engineering, University of Delaware, Newark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Rosen","sequence":"first","affiliation":[{"name":"Psychological and Brain Sciences, University of Delaware, Newark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles \u201cBuz\u201d","family":"Swanik","sequence":"first","affiliation":[{"name":"Departments of Kinesiology and Applied Physiology, University of Delaware, Newark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2557","reference":[{"issue":"4","key":"2020060414141257300_i1062-6050-54-12-1269-b01","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1111\/sms.12315","article-title":"An acoustic startle alters knee joint stiffness and neuromuscular control","volume":"25","author":"DeAngelis","year":"2015","journal-title":"Scand J Med Sci Sports"},{"issue":"2","key":"2020060414141257300_i1062-6050-54-12-1269-b02","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1123\/jsr.6.2.182","article-title":"Reestablishing proprioception and neuromuscular control in the ACL-injured athlete","volume":"6","author":"Swanik","year":"1997","journal-title":"J Sport Rehabil"},{"issue":"suppl 1","key":"2020060414141257300_i1062-6050-54-12-1269-b03","doi-asserted-by":"crossref","first-page":"i47","DOI":"10.1136\/bjsm.2007.037192","article-title":"Mechanisms of non-contact ACL injuries","volume":"41","author":"Yu","year":"2007","journal-title":"Br J Sports Med"},{"issue":"425","key":"2020060414141257300_i1062-6050-54-12-1269-b04","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1097\/00003086-200408000-00027","article-title":"Neuromuscular dynamic restraint in women with anterior cruciate ligament injuries","author":"Swanik","year":"2004","journal-title":"Clin Orthop Relat Res"},{"key":"2020060414141257300_i1062-6050-54-12-1269-b05","first-page":"743","article-title":"The organization and planning of movement","author":"Wolpert","year":"2013","journal-title":"Principles of Neural Science. 5th ed"},{"issue":"1","key":"2020060414141257300_i1062-6050-54-12-1269-b06","first-page":"80","article-title":"The sensorimotor system, part II: the role of proprioception in motor control and functional joint stability","volume":"37","author":"Riemann","year":"2002","journal-title":"J Athl Train"},{"issue":"12","key":"2020060414141257300_i1062-6050-54-12-1269-b07","doi-asserted-by":"crossref","first-page":"2419","DOI":"10.1177\/0363546509343201","article-title":"Anterior cruciate ligament deficiency causes brain plasticity: a functional MRI study","volume":"37","author":"Kapreli","year":"2009","journal-title":"Am J Sports Med"},{"issue":"10","key":"2020060414141257300_i1062-6050-54-12-1269-b08","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.4085\/1062-6050-50.10.08","article-title":"Brains and sprains: the brain's role in noncontact anterior cruciate ligament injuries","volume":"50","author":"Swanik","year":"2015","journal-title":"J Athl Train"},{"issue":"7","key":"2020060414141257300_i1062-6050-54-12-1269-b09","doi-asserted-by":"crossref","first-page":"1549","DOI":"10.1177\/0363546513489284","article-title":"Psychological responses matter in returning to preinjury level of sport after anterior cruciate ligament reconstruction surgery","volume":"41","author":"Ardern","year":"2013","journal-title":"Am J Sports Med"},{"key":"2020060414141257300_i1062-6050-54-12-1269-b10","first-page":"1079","article-title":"Emotions and feelings","author":"LeDoux","year":"2013","journal-title":"Principles of Neural Science"},{"issue":"6","key":"2020060414141257300_i1062-6050-54-12-1269-b11","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1038\/35077500","article-title":"Primate anterior cingulate cortex: where motor control, drive and cognition interface","volume":"2","author":"Paus","year":"2001","journal-title":"Nat Rev Neurosci"},{"issue":"8","key":"2020060414141257300_i1062-6050-54-12-1269-b12","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1016\/j.psyneuen.2011.12.010","article-title":"Acute psychosocial stress: does the emotional stress response correspond with physiological responses?","volume":"37","author":"Campbell","year":"2012","journal-title":"Psychoneuroendocrinology"},{"issue":"6","key":"2020060414141257300_i1062-6050-54-12-1269-b13","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1177\/0363546507299532","article-title":"The relationship between neurocognitive function and noncontact anterior cruciate ligament injuries","volume":"35","author":"Swanik","year":"2007","journal-title":"Am J Sports Med"},{"key":"2020060414141257300_i1062-6050-54-12-1269-b14","first-page":"1056","article-title":"The autonomic motor system and the hypothalamus","author":"Horn","year":"2013","journal-title":"Principles of Neural Science"},{"key":"2020060414141257300_i1062-6050-54-12-1269-b15","unstructured":"Lang\n              PJ\n            , BradleyMM, CuthbertBN. \n          International Affective Picture System (IAPS): Affective Ratings of Pictures and Instruction Manual. Gainesville, FL: University of Florida;2008."},{"issue":"1","key":"2020060414141257300_i1062-6050-54-12-1269-b16","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/j.jbtep.2011.07.006","article-title":"Identifying a subset of fear-evoking pictures from the IAPS on the basis of dimensional and categorical ratings for a German sample","volume":"43","author":"Barke","year":"2012","journal-title":"J Behav Ther Exp Psychiatry"},{"issue":"12","key":"2020060414141257300_i1062-6050-54-12-1269-b17","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1016\/j.arthro.2007.07.003","article-title":"A meta-analysis of the incidence of anterior cruciate ligament tears as a function of gender, sport, and a knee injury-reduction regimen","volume":"23","author":"Prodromos","year":"2007","journal-title":"Arthroscopy"},{"key":"2020060414141257300_i1062-6050-54-12-1269-b18","first-page":"29","article-title":"The International Affective Picture System (IAPS) in the study of emotion and attention","author":"Lang","year":"2007","journal-title":"Handbook of Emotion Elicitation and Assessment"},{"issue":"11","key":"2020060414141257300_i1062-6050-54-12-1269-b19","doi-asserted-by":"crossref","first-page":"2424","DOI":"10.1016\/j.clinph.2006.06.754","article-title":"A theoretical basis for standing and traveling brain waves measured with human EEG with implications for an integrated consciousness","volume":"117","author":"Nunez","year":"2006","journal-title":"Clin Neurophysiol"},{"issue":"3","key":"2020060414141257300_i1062-6050-54-12-1269-b20","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.biopsycho.2004.09.001","article-title":"State anxiety and affective physiology: effects of sustained exposure to affective pictures","volume":"69","author":"Smith","year":"2005","journal-title":"Biol Psychol"},{"issue":"3","key":"2020060414141257300_i1062-6050-54-12-1269-b21","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1037\/1528-3542.1.3.276","article-title":"Emotion and motivation, I: defensive and appetitive reactions in picture processing","volume":"1","author":"Bradley","year":"2001","journal-title":"Emotion"},{"key":"2020060414141257300_i1062-6050-54-12-1269-b22","first-page":"581","article-title":"Emotion and motivation","author":"Bradley","year":"2006","journal-title":"Handbook of Psychophysiology. 2nd ed"},{"issue":"2","key":"2020060414141257300_i1062-6050-54-12-1269-b23","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1111\/j.1469-8986.2009.00940.x","article-title":"Is freezing an adaptive reaction to threat? Evidence from heart rate reactivity to emotional pictures in victims of war and torture","volume":"47","author":"Adenauer","year":"2010","journal-title":"Psychophysiology"},{"issue":"10","key":"2020060414141257300_i1062-6050-54-12-1269-b24","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1016\/j.psyneuen.2005.03.019","article-title":"The role of the amygdala in human fear: automatic detection of threat","volume":"30","author":"Ohman","year":"2005","journal-title":"Psychoneuroendocrinology"},{"issue":"1","key":"2020060414141257300_i1062-6050-54-12-1269-b25","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1016\/j.neuroimage.2004.01.012","article-title":"Dissociable amygdala and orbitofrontal responses during reversal fear conditioning","volume":"22","author":"Morris","year":"2004","journal-title":"Neuroimage"},{"issue":"36","key":"2020060414141257300_i1062-6050-54-12-1269-b26","doi-asserted-by":"crossref","first-page":"9264","DOI":"10.1523\/JNEUROSCI.1016-06.2006","article-title":"Mode of functional connectivity in amygdala pathways dissociates level of awareness for signals of fear","volume":"26","author":"Williams","year":"2006","journal-title":"J Neurosci"},{"key":"2020060414141257300_i1062-6050-54-12-1269-b27","first-page":"392","article-title":"The organization of cognition","author":"Olson","year":"2013","journal-title":"Principles of Neural Science. 5th ed"},{"issue":"3","key":"2020060414141257300_i1062-6050-54-12-1269-b28","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1152\/jn.1988.60.3.1110","article-title":"Muscle stiffness in human ankle dorsiflexors: intrinsic and reflex components","volume":"60","author":"Sinkjaer","year":"1988","journal-title":"J Neurophysiol"},{"issue":"1","key":"2020060414141257300_i1062-6050-54-12-1269-b29","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.neuroimage.2004.08.016","article-title":"A direct brainstem-amygdala-cortical \u2018alarm' system for subliminal signals of fear","volume":"24","author":"Liddell","year":"2005","journal-title":"Neuroimage"},{"key":"2020060414141257300_i1062-6050-54-12-1269-b30","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.clinbiomech.2016.04.010","article-title":"A sex comparison of reactive knee stiffness regulation strategies under cognitive loads","volume":"35","author":"Kim","year":"2016","journal-title":"Clin Biomech (Bristol, Avon)"}],"container-title":["Journal of Athletic Training"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/meridian.allenpress.com\/jat\/article-pdf\/54\/12\/1269\/2468426\/1062-6050-246-18.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/meridian.allenpress.com\/jat\/article-pdf\/54\/12\/1269\/2468426\/1062-6050-246-18.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T18:51:43Z","timestamp":1749667903000},"score":1,"resource":{"primary":{"URL":"https:\/\/nata.kglmeridian.com\/view\/journals\/attr\/54\/12\/article-p1269.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,1]]},"references-count":30,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2019,12,1]]}},"URL":"https:\/\/doi.org\/10.4085\/1062-6050-246-18","relation":{},"ISSN":["1062-6050"],"issn-type":[{"value":"1062-6050","type":"print"}],"subject":[],"published":{"date-parts":[[2019,12,1]]}}}