Effect of Neurocognition and Concussion on Musculoskeletal Injury Risk

Abstract

Research regarding musculoskeletal injury risk has focused primarily on anatomical, neuromuscular, hormonal, and environmental risk factors; however, subsequent injury risk screening and intervention programs have been largely limited to neuromuscular factors and have faced challenges in both implementation and efficacy. Recent studies indicate that poor neurocognitive performance, either at baseline or in the aftermath of a concussion, is associated with elevated risk of musculoskeletal injury. Despite the relatively limited current understanding regarding the nature of the relationship between different aspects of neurocognitive performance and musculoskeletal injury risk, this is a promising area of research that may yield significant advances in musculoskeletal injury risk stratification, rehabilitation, and prevention.

Association Between Concussion and Lower Extremity Injuries in Collegiate Athletes

“…This study design, similar to that by Pietrosimone et al, 39 was unable to ascertain a directional or causative relationship; however, these findings may assist clinicians in targeting and developing injury prevention programs to reduce musculoskeletal injuries after concussion. 19 …”

“…39 Transient alterations in neurocognitive function, which may be exacerbated postconcussion by psychological stress and inadequate sleep, may contribute to elevated injury risk. 19 Postconcussion changes in cerebral functioning including prolonged deficits in attentional resource allocation and cognitive processing speed adversely affects postural control beyond the acute injury phrase. 3 There may be an elevated risk of injury both prior to and after a concussion, suggesting these individuals could be injury prone or partake in higher risk activities, which elevates the likelihood of all injuries.…”

What are the critical elements of sideline screening that can be used to establish the diagnosis of concussion? A systematic review

“…Sustaining a SRC may increase the likelihood of incurring a subsequent head or musculoskeletal injury,3 and repeated concussions could be associated with long-term consequences such as persistent postconcussive symptoms, depression or neurodegenerative disorders 1 4 5. Early detection of suspected concussion and removal of the affected player will help prevent these potential adverse sequelae and facilitate further evaluation, management and safe return to play.…”

Use of Objective Neurocognitive Measures to Assess the Psychological States that Influence Return to Sport Following Injury

“…The psychological state of the individual, when properly measured neurocognitively, will identify characteristics and patterns of brain activity and allow for objective classification improving clinical outcomes [24,25]. Neurocognition refers to correlating emotional / psychological factors and cognitive processing with physiological patterns of neural activity [25].…”

“…Neurocognition refers to correlating emotional / psychological factors and cognitive processing with physiological patterns of neural activity [25]. Thus, we discuss various neurocognitive methodologies that could be utilized in future research for objectively measuring psychological states of athletes attempting to RTS.…”