In a recent viewpoint, Alli Gokeler and colleagues make an argument on the importance of viewing ACL Injuries with a neurocognitive lens. They conclude that there is a need to broaden our scope of ACL injury mechanisms and screening for ACL injury. Integrating a neurocognitive approach to the existing biomechanical and neuromuscular approach would enhance our understanding of the ACL injury mechanisms’ complexity.
What is already known
ACL injuries are predominantly viewed from a biomechanical perspective
ACL injury screening is commonly done with predictable closed-skills tasks
What are the new arguments
Neurocognitive errors may contribute to ACL injuries
Open skill tasks should be considered to assess coordination
ACL injury screening should include sport-specific neurocognitive demands
Athletes in team sports have to quickly visually perceive the actions of opponents and teammates while executing their own movements. These continuous actions are performed under time pressure and may contribute to a non-contact ACL injury. However, ACL injury screening and prevention programmes are primarily based on standardised movements in a predictable environment.
The sports environment provides much greater cognitive demand because athletes must attend their attention to numerous external stimuli and inhibit impulsive actions. Any deficit or delay in attentional processing may contribute to an inability to correct potential errors in complex coordination, resulting in knee positions that increase the ACL injury risk. In this viewpoint, we advocate that ACL injury screening should include sports-specific neurocognitive demands.
You may also want to check Alli’s brand new “Motor Learning Institute” for further resources.
The full viewpoint can be accessed here (Open Access)
Gokeler A, Benjaminse A, Della Villa F, Tosarelli F, Verhagen E, Baumeister J. Anterior cruciate ligament injury mechanisms through a neurocognitive lens: implications for injury screening. BMJ Open
Sport & Exercise Medicine 2021;7:e001091. doi:10.1136/ bmjsem-2021-001091