Enhancing Return to Alpine Skiing: Integrating Perceptual-Motor-Cognitive Considerations in Testing and Progressions:...

Area of Science:

• Sports Medicine
• Orthopedics
• Rehabilitation Science

Background:

• Alpine skiing presents a high risk for anterior cruciate ligament (ACL) injuries, with significant re-injury rates.
• Existing return to sport (RTS) and return to snow protocols have not effectively reduced ACL re-injury frequency.
• Current protocols often isolate biomechanical and neuromuscular factors, neglecting cognitive and perceptual-motor aspects crucial for skiing.

Purpose of the Study:

• To address the unique perceptual-motor-cognitive demands of alpine skiing.
• To critically evaluate current RTS testing methodologies for skiers.
• To propose enhanced RTS and return to snow standards incorporating cognitive-perceptual-motor elements.

Main Methods:

• This is a clinical commentary, not an experimental study.
• It involves a critical review of existing literature and protocols.
• It synthesizes current understanding of ACL injury, skiing demands, and cognitive science.

Main Results:

• Current RTS protocols for alpine skiers may be inadequate due to their narrow focus.
• The cognitive and perceptual-motor demands of alpine skiing are substantial and often overlooked in RTS assessments.
• A gap exists in current RTS protocols regarding the integration of cognitive-perceptual-motor evaluations.

Conclusions:

• Updated RTS and return to snow protocols are needed for alpine skiers.
• These updated protocols must integrate assessments of perceptual-motor-cognitive function alongside biomechanical and neuromuscular factors.
• Addressing these comprehensive demands may help mitigate ACL re-injury rates in alpine skiing.