University of Nevada, Las Vegas, Las Vegas, Nevada, USA.
Am J Sports Med. 2022 Feb;50(2):554-562. doi: 10.1177/0363546521998081. Epub 2021 Mar 19.
While a large number of studies have investigated the anatomic, hormonal, and biomechanical risk factors related to musculoskeletal (MSK) injury risk, there is growing evidence to suggest that cognition is an important injury contributor in the athletic population. A systematic review of the available evidence regarding the influence of cognitive performance on MSK injury risk has yet to be published in the sports medicine literature.
PURPOSE/HYPOTHESIS: The purpose was to determine the effects of cognition on (1) MSK biomechanics during sports-specific tasks and (2) MSK injury occurrence in the athletic population. It was hypothesized that athletes with lower cognitive performance would demonstrate biomechanical patterns suggestive of MSK injury risk and that injured athletes would perform worse on baseline measures of cognition as compared with their noninjured counterparts.
Systematic review.
PubMed and SPORTDiscus were searched from January 2000 to January 2020. Manual searches were performed on the reference lists of the included studies. A search of the literature was performed for studies published in English that reported MSK biomechanics as a function of cognitive performance and MSK injury occurrence after baseline measures of cognition. Two independent reviewers extracted pertinent study data in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2009 guidelines and assessed study quality using the Quality Assessment Tool for Observational Cohort and Cross-sectional Studies from the National Institutes of Health. A meta-analysis was not performed, owing to the heterogeneous nature of the study designs.
Ten studies met inclusion criteria: 4 cognition-MSK biomechanics studies and 6 cognition-MSK injury studies. All 4 cognition-MSK biomechanics studies demonstrated that worse performance on measures of cognition was associated with lower extremity MSK biomechanical patterns suggestive of greater risk for MSK injury. The majority of the cognition-MSK injury studies demonstrated that injured athletes significantly differed on baseline cognition measures versus matched controls or that cognitive performance was a significant predictor for subsequent MSK injury.
Although the literature exploring cognitive contributions to MSK injury risk is still in its infancy, it is suggested that sports medicine personnel conduct baseline assessments of cognition-in particular, reaction time and working memory-to identify which athletes may be at elevated risk for future MSK injury.
虽然大量研究已经调查了与肌肉骨骼（MSK）损伤风险相关的解剖学、激素和生物力学风险因素，但越来越多的证据表明，认知是运动人群中重要的损伤因素。然而，在运动医学文献中，还没有关于认知表现对 MSK 损伤风险影响的系统评价。
目的/假设：目的是确定认知对（1）运动专项任务中的 MSK 生物力学和（2）运动员人群中的 MSK 损伤发生的影响。假设认知能力较低的运动员表现出的生物力学模式表明存在 MSK 损伤风险，并且与未受伤的运动员相比，受伤的运动员在认知的基线测量中表现更差。
系统评价。
从 2000 年 1 月至 2020 年 1 月，在 PubMed 和 SPORTDiscus 上进行了搜索。对纳入研究的参考文献进行了手工搜索。对发表的以认知表现为 MSK 生物力学功能以及认知基线测量后的 MSK 损伤发生为研究内容的英文文献进行了检索。两名独立的审查员根据 PRISMA（系统评价和荟萃分析的首选报告项目）2009 指南提取相关研究数据，并使用美国国立卫生研究院的观察性队列和横断面研究质量评估工具评估研究质量。由于研究设计的异质性，未进行荟萃分析。
10 项研究符合纳入标准：4 项认知-MSK 生物力学研究和 6 项认知-MSK 损伤研究。所有 4 项认知-MSK 生物力学研究都表明，认知测试表现较差与下肢 MSK 生物力学模式相关，这些模式提示 MSK 损伤风险增加。大多数认知-MSK 损伤研究表明，受伤的运动员在认知的基线测量中与匹配的对照组有显著差异，或者认知表现是随后发生 MSK 损伤的显著预测因素。
尽管探索认知对 MSK 损伤风险的贡献的文献仍处于起步阶段，但建议运动医学人员对认知进行基线评估-特别是反应时间和工作记忆-以确定哪些运动员可能有更高的未来 MSK 损伤风险。
