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Neuromuscular and Neurocognitive Performance Associated with ACL Injury Risk in Youth Handball Players: A Prospective
Gréta Csilla Sinka1, Attila Pavlik2,3, Ágnes Mayer4
1Doctoral College, Semmelweis University, 1085 Budapest, Hungary.
Sports (Basel, Switzerland)
|May 26, 2026
Summary
Neuromuscular factors like longer ground contact time and being female predict anterior cruciate ligament (ACL) injuries in young athletes. Cognitive tests did not predict ACL injury risk independently.
Area of Science:
- Sports Medicine
- Biomechanics
- Orthopedics
Background:
- Anterior cruciate ligament (ACL) injuries are common in youth athletes.
- The roles of neuromuscular and neurocognitive factors in ACL injuries are not fully understood.
Purpose of the Study:
- To investigate the predictive ability of neuromuscular and neurocognitive variables for ACL injuries in young handball players.
Main Methods:
- Prospective cohort study of 220 youth handball players.
- Functional testing (Back in Action) and neurocognitive evaluation (ImPACT).
- 24-month follow-up for ACL injury identification via MRI.
Main Results:
- 26 athletes sustained ACL injuries over 24 months.
- Prolonged plyometric ground contact time was a significant predictor (OR=0.98).
- Female sex was an independent risk factor (OR=5.74).
Conclusions:
- Neuromuscular performance (ground contact time) and female sex predict ACL injuries in youth handball.
- Cognitive assessments alone did not differentiate injury risk.
- Objective neuromuscular evaluation is valuable for injury prevention strategies.
