Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran, Iran.
Department of Applied Physiology, Health, and Clinical Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA.
J Sport Rehabil. 2024 Aug 8;33(7):485-494. doi: 10.1123/jsr.2023-0428. Print 2024 Sep 1.
The best current evidence supports the effectiveness of neuromuscular training in reducing the risk of injury; however, the rate of anterior cruciate ligament (ACL) injuries is still high. Neurocognitive training (NT) has successfully improved biomechanical risk factors, but they have been considered in only a few studies.
To review the literature to determine the effect of NT on biomechanical risk factors related to ACL injury in athletes.
We searched PubMed, Google Scholar, Scopus, Science Direct, and the Physiotherapy Evidence Database from inception to August 2011. We included randomized controlled trials that used motor learning approaches and injury prevention programs to investigate kinematic and kinetic risk factors related to ACL injury. The quality of each clinical trial study was evaluated by the Physiotherapy Evidence Database scale. The eligibility criteria were checked based on the PICOS (population, intervention, comparison, outcome, and study type) framework.
A total of 9 studies were included in the final analysis. Motor learning approaches include internal and external focus of attention, dual tasks, visual motor training, self-control feedback, differential learning, and linear and nonlinear pedagogy, combined with exercise programs. In most of the studies that used NT, a significant decrease in knee valgus; tibial abduction and external rotation; ground reaction force; and an increase in knee-, trunk-, hip-, and knee-flexion moment was observed.
In classical NT, deviation from the ideal movement pattern especially emphasizing variability and self-discovery processes is functional in injury prevention and may mitigate biomechanical risk factors of ACL injuries in athletes. Practitioners are advised to use sport-specific cognitive tasks in combination with neuromuscular training to simulate loads of the competitive environment. This may improve ACL injury risk reduction and rehabilitation programs.
目前最佳证据支持神经肌肉训练可降低损伤风险；然而，前交叉韧带（ACL）损伤的发生率仍然很高。神经认知训练（NT）已成功改善了生物力学危险因素，但在为数不多的研究中对其进行了考虑。
综述文献以确定 NT 对与运动员 ACL 损伤相关的生物力学危险因素的影响。
我们检索了 PubMed、Google Scholar、Scopus、Science Direct 和 Physiotherapy Evidence Database，时间从建库至 2011 年 8 月。我们纳入了使用运动学习方法和损伤预防方案来调查与 ACL 损伤相关的运动学和动力学危险因素的随机对照试验。通过 Physiotherapy Evidence Database 量表评估每个临床试验研究的质量。根据 PICOS（人群、干预、比较、结局和研究类型）框架检查入选标准。
共有 9 项研究最终纳入分析。运动学习方法包括内部和外部注意力焦点、双重任务、视觉运动训练、自我控制反馈、差异学习以及线性和非线性教学法，结合运动方案。在大多数使用 NT 的研究中，观察到膝外翻、胫骨外展和外旋、地面反作用力以及膝关节、躯干、髋关节和膝关节屈伸力矩的显著降低。
在经典的 NT 中，对理想运动模式的偏离，特别是强调变异性和自我发现过程的偏离，对预防损伤是有效的，并且可能减轻运动员 ACL 损伤的生物力学危险因素。建议从业者使用特定于运动的认知任务与神经肌肉训练相结合，以模拟竞技环境的负荷。这可能会改善 ACL 损伤的风险降低和康复方案。
