(18) DISCREPANCIES IN VISUAL ATTENTION TOWARD TASK-RELEVANT STIMULI IN COLLEGIATE WOMEN SOCCER PLAYERS POST-ACL RECONSTRUCTION: A PILOT STUDY

Purpose: Physical therapy and injury prevention training after anterior cruciate ligament reconstruction (ACLr) often focuses on restoring lower extremity muscle strength and creating healthy movement patterns. Despite improvements from these interventions, results are often insufficient to return athletes to preinjury performance levels. Neurocognitive factors like visual attention, which are essential for movements requiring an external focus of attention or unplanned reactions, may play a critical role in reducing reinjury risk. The purpose of this study was to examine if visual attention differs in athletes after they are cleared to return to sport post-ACLr, specifically in collegiate women soccer players. Methods: After IRB approval, 8 collegiate women soccer athletes (n = 2 post-ACLr) completed 3 trials of the Loughborough Soccer Passing Test while wearing a mobile eye-tracking device to capture visual attention, via measures of average fixation duration (average time spent focusing within a given time period) and fixation count (number of fixations on specific locations within the environment). Results: Repeated measures ANOVA found no differences in average fixation duration between post-ACLr (M = 0.142 ± 0.047 s) and healthy controls (M = 0.142 ± 0.061 s) or across trials. Next, when analyzing the number of fixations directed toward passing targets (i.e., task-relevant stimuli), we observed group differences were not statistically significant (F(1, 6) = 1.19, p = 0.31), however there was a large effect size (Cohen’s d = 0.85). Specifically, the ACLr group made two total fixations toward passing targets across all trials, compared to 20 in the control group. Conclusions: This pilot study aimed to investigate whether athletes cleared to return to sport exhibit deficits in visual attention that may contribute to reinjury risk. Although no significant differences in overall visual attention were found, a meaningful effect was observed in the number of fixations directed at the passing target. Together these results suggest athletes post-ACLr maintained similar focus durations to their non-injured peers, however, they struggled with directing their attention to task-relevant stimuli (i.e., passing targets), which potentially could affect athletes’ post-ACLr coordination and decision-making during sport. Practical Applications: This pilot study underscores a potential gap in traditional rehabilitation protocols - the persistence of visual attention deficits even after athletes are cleared for return to play. Visual attention towards task-relevant stimuli should be considered in training post-rehabilitation. For example, strength and conditioning coaches adding visual stimuli to footwork and change of direction drills increases the cognitive load of the drills, while training the athlete to direct their visual attention into the plane of play for their sport (e.g., looking up and around versus down at the ground). Further building on these non-decision-making tasks, strength and conditioning coaches can build up to agility training drills including cognitive decision making and reaction, as well as eventually advancing to athletes’ practicing pattern recognition to inform their decisions during the agility exercise. Incorporating exercises such as those described can improve visual tracking, decision-making, and reaction time, which may enhance athletes' ability to process environmental cues effectively and reduce the risk of reinjury; thereby bridging the gap between being cleared & ready for sport. Acknowledgements: None.