Lower Kinetic Chain, Meet the Thinking Brain: A Scoping Review of Cognitive Function and Lower Extremity Injury Risk

Area of Science:

• Sports Medicine
• Neuroscience
• Biomechanics

Background:

• Traditional non-contact anterior cruciate ligament (ACL) injury models focus on environmental, anatomical, hormonal, and biomechanical factors.
• Cognitive function's role in athletic performance is recognized, but its contribution to injury risk is often overlooked.

Purpose of the Study:

• To review existing literature on how cognitive function (ability and task load) influences non-contact lower extremity (LE) injury risk in athletes.
• To assess the impact of cognitive factors across diverse athletic populations and expertise levels.

Main Methods:

• A comprehensive scoping review was conducted using PRISMA methodology across multiple databases (CINAHL, SPORTDiscus, Google Scholar, MEDLINE).
• Search terms combined cognitive descriptors (cognition, concussion, mTBI, etc.) with injury descriptors (injury risk, LE injury).
• Studies published between 2000-2021 in English were included, with specific criteria for cognitive and neurological conditions.

Main Results:

• Fifty-six studies met inclusion criteria, with most (41) of good methodological quality.
• Studies explored baseline cognitive function, dual-task performance, and the effects of concussion on LE injury risk.
• A significant association was found between decreased cognitive ability or increased cognitive load and risky LE mechanics or increased non-contact LE injury.

Conclusions:

• Overwhelmingly, studies indicate that diminished cognitive function or heightened cognitive demand increases LE injury risk.
• These findings suggest that cognitive training should be considered in LE injury prevention programs.
• The results are robust across various demographics, sports, and cognitive measures.