Sensory-Motor Function and Postural Control in Female Volleyball Players with and Without Cognitive Errors During Dual-Task Performance: A Cross-sectional Study

Abstract

Background: Dual-task performance, which involves concurrent cognitive and motor demands, is important for volleyball players who must coordinate tactical decisions with dynamic movements. Cognitive errors during such tasks may indicate sensory-motor control deficits and an increased risk of injury. Objectives: This study aimed to compare baseline sensory-motor function, including tuck jump assessment (TJA) score, knee and ankle proprioception, lower limb strength, and postural control, between female volleyball players classified by their cognitive performance (with or without cognitive errors) during dual-task execution. Methods: In this cross-sectional study conducted between May and July 2024, 82 female volleyball players (mean age of 20.35 ± 1.84 years) participated. Athletes performed the TJA under dual-task conditions, which included a working-memory task requiring participants to recall and repeat five sequential numbers in the correct order. Based on cognitive accuracy, participants were classified into a “without cognitive error” group and a “with cognitive error” group; participants were classified as making a cognitive error if they failed to recall the full number sequence correctly. The TJA score, joint position sense error, muscle strength, and static balance were measured using the tuck jump task, goniometer, handheld dynamometer, and foot scan system, respectively. Data were analyzed using multivariate analysis of variance, and effect sizes (η2p) were calculated to interpret the magnitude of group differences. Results: Compared to the group without cognitive error, athletes with cognitive errors showed significantly higher TJA scores (P = 0.001; η2p = 0.4, large effect), greater proprioceptive errors at the knee (P = 0.026; η2p = 0.061, medium effect) and ankle (P = 0.001; η2p = 0.177, large effect), and reduced strength of the knee extensors (P = 0.004; η2p = 0.098, medium to large effect), hip adductor (P = 0.045; η2p = 0.049, small to medium effect) and hip abductor (P = 0.003; η2p = 0.104, medium to large effect) muscles. Postural sway parameters differed only under eyes-closed conditions, with the cognitive error group showing greater ellipse area of center of pressure (CoP, P = 0.041; η2p = 0.051, small to medium effect). Conclusions: Cognitive errors during dual-task execution in female volleyball players are associated with deficits in proprioception, lower-limb strength, and postural control. Dual-task testing may help identify athletes at risk and inform targeted cognitive-motor training to improve performance and reduce injury risk.