Integrating neurocognitive challenges into injury prevention training: A clinical commentary

Despite the efforts of many traditional lower extremity injury prevention programs (IPP), the incidence of anterior cruciate ligament injuries in young athletes continues to rise. Current best practices for IPPs include training lower extremity neuromuscular control and movement quality during cutting, jumping, and pivoting. Emerging evidence indicates neurocognition may contribute to injury incidence and injury risk biomechanics. Therefore, IPP outcomes may improve if clinicians also consider neurocognitive contributions to neuromuscular control and athletic performance. A substantial barrier to neurocognitive challenge integration during injury prevention training in the group setting is the lack of structured neuromuscular and neurocognitive progressions. Therefore, our aim is to provide clinicians with a defined framework and recommendations from clinical experience for how to implement neurocognitive challenges within group IPPs that requires minimal extra time and resources. This clinical commentary proposes a three-phase model adopted from motor learning literature to simultaneously progress neuromuscular and neurocognitive challenges through a structured IPP.