Related Experiment Video
Updated: Aug 13, 2025
Author Spotlight: Implementing the Enhanced Recovery After Surgery Concept in Rehabilitation Following Anterior Cruciate Ligament Reconstruction
Published on: March 1, 2024
Associations Between Cognitive Function and ACL Injury-Related Biomechanics: A Systematic Review
Filippo Bertozzi1,2,3, Patrick D Fischer4, Keith A Hutchison5
1Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.
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.
More Related Videos
06:27Author Spotlight: Investigating Early Events and Long-Term Effects of ACL Injuries for Osteoarthritis Progression
Published on: September 29, 2023
07:52Evaluating Postural Control and Lower-extremity Muscle Activation in Individuals with Chronic Ankle Instability
Published on: September 18, 2020