Neurocognitive Errors and Noncontact Anterior Cruciate Ligament Injuries in Professional Male Soccer Players

Abstract

Context Evidence is emerging that core neurocognitive function such as working memory or inhibitory control (more response inhibition, attention) are linked to ACL injury risk. Thus far, research has been conducted in laboratory settings and the contribution of neurocognition to actual ACL injuries under real world conditions is unknown. Objective We hypothesized that errors in motor response inhibition and attentional inhibition contribute to non-contact ACL injuries in professional soccer players. In addition, we hypothesized high inter-rater agreement for the neurocognitive assessment based on the video analysis. Design Case series Setting Soccer matches Patients or Other participants Professional male soccer players Main Outcome Measures Neurocognitive errors in inhibitory control were operationalized as 1) motor response inhibition was scored when a player demonstrated poor decision making and approached the opponent with high speed which reduced the ability to stop or change the intended action; 2) an attentional error was scored in case the player shifted the selective attention away from the relevant task to irrelevant stimuli. Three independent reviewers evaluated each video. Results A total of 47 actual ACL injury videos were analyzed. Out of 47 non-contact ACL injuries, 26 were related to a pressing type injury and in 19 (73%) there was a deceiving action made by the opponent suggestive for poor inhibitory control of the defender. For the remaining 21 non-contact ACL injuries, 16 (76%) could be attributed to attentional errors. The agreement between the three raters was very good for all items, except for item poor decision making which showed fair to good agreement (0.71). Inter-rater reliability was excellent (ICC = 0.998–1.00). Conclusion The current student found that errors in motor response inhibitory control and attentional inhibition are common during non-contact ACL injury events in professional male soccer players. The inter-rater agreement to detect neurocognitive errors in general is very good.

Graded treadmill running protocol on dynamic visual acuity and balance for athletes with and without recent concussion history

“…Such a rapid mechanism of injury cannot be attributable to biomechanical errors, such as dynamic knee valgus, suggesting that visuomotor processing de cits may affect risk of injury. Interestingly, athletes who have sustained non-contact ACL tears have demonstrated neurocognitive impairments similar to those detected following SRC, including slower reaction times and visual processing de cits(Gokeler et al, 2023;Swanik et al, 2007). The current ndings suggest that DVA could be a meaningful clinical measure of both visual function and neurocognition to further explore the boundaries of attentional capacity for athletes using different balance and exercise constraints.The current ndings did not agree with our secondary hypothesis, such that the treadmill running protocol resulted in transient changes in balance control similarly for both ATHLETE and CONC groups.…”

Four distinct patterns of anterior cruciate ligament injury in women’s professional football (soccer): a systematic video analysis of 37 match injuries

“…Further research should investigate why such mechanically simple horizontal deceleration manoeuvres lead to match injuries in women’s football, whereas male athletes are typically injured during more strenuous jumping manoeuvres 21 38 39. Due to the close proximity and short reaction time of the defender, a high visual and/or cognitive demand can be proposed as a potential neuromuscular mechanism 40…”

“… 21 38 39 Due to the close proximity and short reaction time of the defender, a high visual and/or cognitive demand can be proposed as a potential neuromuscular mechanism. 40 …”

A Model for Applying Situational Awareness Theory to the Return to Sport Continuum

“…8,9 During the reactive "panic" style of coordination, athletes may exhibit impulsive and high injury risk behaviors. 9,16 As task complexity, cognitive load, and attention demand increase, the likelihood of attaining SA decreases. 7 Due to limited at-tention capacity, some components of the environment will demand increased attention, taking attention away from other aspects of the environment.…”

“…7 The culmination of altered cognitive processes that result in diminished SA may result in increased cognitive or movement errors, placing individuals at an increased risk of injury. 16 Furthermore, where working memory falls short, there may be an increased reliance on long-term memory stores and automaticity during reactive control. 7 Automaticity may combat the negative effects of increased uncertainty and time constraints by bypassing the cognitive processes.…”