Citation

Bertozzi F, Fischer PD, Hutchison KA, Zago M, Sforza C, Monfort SM. Sports Health 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, American Orthopaedic Society for Sports Medicine, Publisher SAGE Publishing)

DOI

10.1177/19417381221146557

PMID

36680310

Abstract

CONTEXT: Does lower baseline cognitive function predispose athletes to ACL injury risk, especially when performing unplanned or dual-task movements? OBJECTIVE: To evaluate the association between cognitive function and biomechanics related to ACL injuries during cognitively challenging sports movements. DATA SOURCES: PubMed (MEDLINE), Web of Science, Scopus, and SciELO databases were searched; additional hand searching was also conducted. STUDY SELECTION: The following inclusion criteria had to be met: participants completed (1) a neurocognitive test, (2) a cognitively challenging sport-related task involving lower limbs, and (3) a biomechanical analysis. The following criteria determined exclusion from the review: studies involving participants with (1) recent or current musculoskeletal injuries; (2) recent or current concussion; (3) ACL surgical reconstruction, reviews of the literature, commentary or opinion articles, and case studies. STUDY DESIGN: Systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) statement and registered at the International Prospective Register of Systematic Reviews (PROSPERO). LEVEL OF EVIDENCE: Level 3. DATA EXTRACTION: Two of authors independently extracted data and assessed the methodological quality of the articles with the Downs and Black and ROBINS-I checklists, to assess methodological quality and risk of bias, respectively.

RESULTS: Six studies with different methodologies and confounding factors were included in this review. Of these 6 studies, 3 were ranked as high-quality, 3 demonstrated a low risk of bias, 2 a moderate risk, and 1 a severe risk. Five studies found a cognitive-motor relationship, with worse cognitive performance associated with increased injury risk, with 1 study reporting the opposite directionality for 1 variable. One study did not identify any interaction between cognitive function and biomechanical outcomes.

CONCLUSION: Worse cognitive performance is associated with an increased injury risk profile during cognitively challenging movements.

Language: en

Keywords

cognition; ACL; dual-task; sports injuries; unplanned movements