International Journal of Sports Physical Therapy最新文献

{"title":"Changes in Shoulder and Lumbar Injury Incidence in Swimmers After Physical Examination and Exercise Programs.","authors":"Hiroki Takayama, Masatoshi Nakamura, Satoshi Kataura, Shinya Kazekami, Ryosuke Takane, Yosuke Mitomi, Shigeto Nakagawa","doi":"10.26603/001c.126189","DOIUrl":"10.26603/001c.126189","url":null,"abstract":"<p><strong>Background: </strong>Previous injury and physical examination data collected by a physiotherapist were reviewed to investigate the causes of injury among competitive swimmers. Each swimmer received an injury improvement exercise program based on their injury history and physical examination findings.</p><p><strong>Purpose: </strong>The purpose of this study was to identify trends in the number of shoulder and lumbar injuries and discern the effectiveness of exercise programs in swimmers. The authors hypothesize that these efforts would decrease injury rates.</p><p><strong>Study design: </strong>Observational Cohort study.</p><p><strong>Methods: </strong>Thirty-one male high school and college student swimmers underwent a physical examination. Previous injury was considered as pain that lasted for > three weeks or that caused the participant to stop practicing. A questionnaire was administered to all swimmers at the beginning of the study and one year later. The questionnaire assessed the number of injuries sustained and the daily practice hours over the previous year. The injury rate at the first examination and one-year followup was calculated as the number of injury incidents divided by the total number of player hours (1 h of practice is equivalent to 1) for one year, multiplied by 1,000 to obtain the injury rate per 1,000 hours (1000 player hours: 1,000 ph). Shoulder and hip exercise programs were prescribed based on measurement results and previous research.</p><p><strong>Results: </strong>The numbers of injuries seen in the group were 12 shoulder and six lumbar at the first examination, and two shoulder and one lumbar at the one-year followup. The 1,000 ph (95% confidence interval) values were 0.32 (0.13-0.50) and 0.16 (0.03-0.29) at the first examination and 0.05 (0.00-0.12) and 0.03 (0.00-0.07) at the one-year followup for the shoulder and lumbar areas, respectively.</p><p><strong>Conclusions: </strong>The results indicates that exercise programs prescribed after a physical examination may reduce the incidence of injuries in male swimmers over the course of a year.</p><p><strong>Level of evidence: </strong>Level 3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"19 12","pages":"1551-1559"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Injury and Illness Trends in the National Hockey League Following an Abrupt Cessation of Play.","authors":"Adam M Pinkoski, Matthew Davies, Mark Sommerfeldt, Dean T Eurich, Don Voaklander","doi":"10.26603/001c.125738","DOIUrl":"10.26603/001c.125738","url":null,"abstract":"<p><strong>Background: </strong>The National Hockey League (NHL) saw an unprecedented disruption to the competitive calendar due to the COVID-19 pandemic in March of 2020. Returning to play following an abrupt cessation of activity is a known risk factor for athletes.</p><p><strong>Purpose: </strong>To analyze the occurrence and severity of events (injury and illness) in the NHL and to understand any differences in occurrence and severity between pre-pandemic seasons and seasons that immediately followed.</p><p><strong>Study design: </strong>Descriptive Epidemiology Study.</p><p><strong>Methods: </strong>Using a retrospective cohort inclusive of all players on active rosters in the NHL between 2016-2023, public access injury and illness data were collected. Outcome measures included event incidence, period prevalence, and severity (mean days lost; MDL), as well as incidence rate ratio (IRR) comparing pre- and post-pandemic seasons.</p><p><strong>Results: </strong>IRR for illness peaked in December 2021 (IRR = 62.46; 95% CI 13.65 to 285.91). Incidence of upper body injuries was significantly higher in 2020-21 (IRR = 1.70, p = 0.001) and 2021-22 (IRR = 1.40, p = 0.044) compared to pre-pandemic seasons (Incidence = 17.58 injuries / 1000 player-hours). Injury incidence increased as the 2022-23 season progressed (p = 0.004); injury incidence was stable across all other seasons. Mean days lost (MDL) to injury was higher in 2020-21 (MDL = 18.12, p < 0.001), 2021-22 (MDL = 18.46, p = 0.015), and 2022-23 (MDL = 18.12, p < 0.001) compared to pre-pandemic seasons (MDL = 17.34).</p><p><strong>Conclusion: </strong>Incidence of upper body injuries increased in the 2020-21 and 2021-22 NHL regular seasons while it decreased significantly in the 2022-23 regular season compared with the four pre-pandemic seasons. This suggests a need to examine if modifiable risk factors exist for determining optimal return to play strategies following an abrupt cessation of play.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"19 12","pages":"1560-1568"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oh, My Quad: A Clinical Commentary And Evidence-Based Framework for the Rehabilitation of Quadriceps Size and Strength after Anterior Cruciate Ligament Reconstruction.","authors":"Braidy Solie, Mitchell Carlson, Christopher Doney, Michael Kiely, Robert LaPrade","doi":"10.26603/001c.126191","DOIUrl":"10.26603/001c.126191","url":null,"abstract":"<p><p>Quadriceps weakness after anterior cruciate ligament reconstruction (ACLR) is a well-known phenomenon, with more persistent quadriceps weakness observed after ACLR with a bone-patellar tendon-bone or quadriceps tendon autograft than with a hamstring tendon autograft. Longstanding quadriceps weakness after ACLR has been associated with suboptimal postoperative outcomes and the progression of radiographic knee osteoarthritis, making the recovery of quadriceps size and strength a key component of ACLR rehabilitation. However, few articles have been written for the specific purpose of optimizing quadriceps size and strength after ACLR. Therefore, the purpose of this review article is to integrate the existing quadriceps muscle basic science and strength training literature into a best-evidence synthesis of exercise methodologies for restoring quadriceps size and strength after ACLR, as well as outline an evidence-informed quadriceps load-progression for recovering the knee's capacity to manage the force-profiles associated with high-demand physical activity. Level of Evidence: 5.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"19 12","pages":"1600-1628"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-rater and Inter-rater Reliability of the KangaTech (KT360) Fixed Frame Dynamometry System During Maximal Isometric Strength Measurements of the Knee Flexors.","authors":"Ellie Woolhead, Richard Partner, Megan Parsley, Ashley Jones","doi":"10.26603/001c.124121","DOIUrl":"10.26603/001c.124121","url":null,"abstract":"<p><strong>Background: </strong>Fixed-frame dynamometry systems are used worldwide to assess isometric strength in both general and athletic populations. There is currently a paucity of published work where reliability estimates for fixed-frame dynamometry systems have been estimated. The aim of this study was to determine the inter-and intra-rater reliability of the KangaTech (KT360) fixed frame dynamometry system when measuring maximal isometric strength of the knee flexor muscles.</p><p><strong>Study design: </strong>Inter and intra-rater reliability single cohort study.</p><p><strong>Methods: </strong>Twenty healthy university-level athletes (age= 21.65 ± 3 years, weight= 74.465 ± 30kg, height= 170.1 ± 7.0cm) took part in two testing sessions where two raters collected data during a 90° hip and knee flexion protocol. Participants performed each test twice, building to a maximal isometric contraction holding over a 5 second period with 30 second rest between sets. Data were checked for normality using a Shapiro-Wilk test. Intraclass correlation coefficient (ICC), standard error of measurement (SEM) and minimal detectable change (MDC) were calculated. Finally, a Bland-Altman analysis was used to determine the levels of agreement for intra-and inter-rater measurements.</p><p><strong>Results: </strong>High levels of agreement were demonstrated between left and right knee flexion as 95% of the differences were less than two standard deviations away from the mean. 'Almost perfect' intraclass correlation coefficient (ICC) values were demonstrated (Knee flexion: Inter-rater: Left, 0.99; Right, 0.99; Intra-rater: Left, 0.99; Right:0.99). Standard error of measurement (SEM) for inter-and intra-rater strength ranged from 0.26-0.69 kg, SEM% ranged from 1.34-2.71% and minimal detectable change (MDC) ranged from 1.14-2.31kg.</p><p><strong>Conclusion: </strong>Overall, high level of inter-and intra-rater reliability were demonstrated when testing maximal isometric knee flexion. Therefore, the KT360 fixed frame dynamometry system may be considered a viable tool for measuring maximal isometric contraction of the knee flexors when repeat measures are required in clinical settings.</p><p><strong>Level of evidence: </strong>3b.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"19 11","pages":"1397-1406"},"PeriodicalIF":1.6,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring Cortical and Neuromuscular Activity: Six-month Insights into Knee Joint Position Sense Following ACL Reconstruction.","authors":"Aglaja Busch, Lorena R R Gianotti, Frank Mayer, Heiner Baur","doi":"10.26603/001c.124840","DOIUrl":"10.26603/001c.124840","url":null,"abstract":"<p><strong>Background: </strong>Changes in cortical activation patterns after rupture of the anterior cruciate ligament (ACL) have been described. However, evidence of these consequences in the early stages following the incident and through longitudinal monitoring is scarce. Further insights could prove valuable in informing evidence-based rehabilitation practices.</p><p><strong>Purpose: </strong>To analyze the angular accuracy, neuromuscular, and cortical activity during a knee joint position sense (JPS) test over the initial six months following ACL reconstruction. Study design: Cohort Study.</p><p><strong>Methods: </strong>Twenty participants with ACL reconstruction performed a JPS test with both limbs. The measurement time points were approximately 1.5, 3-4 and 6 months after surgery, while 20 healthy controls were examined on a single occasion. The active JPS test was performed seated with a target angle of 50° for two blocks of continuous angular reproduction (three minutes per block). The reproduced angles were recorded simultaneously by an electrogoniometer. Neuromuscular activity of the quadriceps muscles during extension to the target angle was measured with surface electromyography. Spectral power for theta, alpha-2, beta-1 and beta-2 frequency bands were determined from electroencephalographic recordings. Linear mixed models were performed with group (ACL or controls), the measurement time point, and respective limb as fixed effect and each grouping per subject combination as random effect with random intercept.</p><p><strong>Results: </strong>Significantly higher beta-2 power over the frontal region of interest was observed at the first measurement time point in the non-involved limb of the ACL group in comparison to the control group (p = 0.03). Despite individual variation, no other statistically significant differences were identified for JPS error, neuromuscular, or other cortical activity.</p><p><strong>Conclusion: </strong>Variation in cortical activity between the ACL and control group were present, which is consistent with published results in later stages of rehabilitation. Both indicate the importance of a neuromuscular and neurocognitive focus in the rehabilitation.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"19 11","pages":"1290-1303"},"PeriodicalIF":1.6,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Power of International Cooperation.","authors":"Mario Bizzini, Ashley M Campbell, Barb Hoogenboom, Michael Voight","doi":"10.26603/001c.125160","DOIUrl":"https://doi.org/10.26603/001c.125160","url":null,"abstract":"","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"19 11","pages":"1289"},"PeriodicalIF":1.6,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hip Stability Isometric Test (HipSIT): Concurrent Validity and Reference Values for CrossFit® Participants.","authors":"Thiago R T Santos, Ana Luiza R Rodrigues, Henrique M P Faria, Stéphane M Teixeira, Livia S Pogetti, Andressa Silva, Renan A Resende, Juliana M Ocarino","doi":"10.26603/001c.124119","DOIUrl":"10.26603/001c.124119","url":null,"abstract":"<p><strong>Background: </strong>The Hip Stability Isometric Test (HipSIT) is a practical clinical assessment of posterolateral hip muscle performance. There is no information regarding the validity of the HipSIT in participants exposed to high-intensity training, such as CrossFit®.</p><p><strong>Purpose: </strong>The purpose of this study was to investigate the Hip Stability Isometric Test (HipSIT) concurrent validity with the isokinetic assessment in CrossFit® participants. A secondary purpose was to characterize posterolateral hip muscular performance with HipSIT according to sex and lower limb dominance in athletes who participate in CrossFit®.</p><p><strong>Study design: </strong>Cross-sectional.</p><p><strong>Methods: </strong>One-hundred and eleven CrossFit® participants were evaluated. The posterolateral hip muscles were evaluated using the HipSIT with a hand-held dynamometer. The hip extensors and abductors' peak torque and maximum work were assessed with the Biodex System® 4 Pro isokinetic dynamometer at 60º/s. Concurrent validity between measurements was assessed with the Spearman correlation coefficient and Bland-Altman analyses. The comparison of results between sexes and between limbs was also performed.</p><p><strong>Results: </strong>Spearman analyses indicated a significant positive correlation with medium effect size between HipSIT and isokinetic variables ( <math><mi>ρ</mi></math> = 0.36 to 0.49). Bland-Altman analyses showed that most measures were within the 95% limits of agreement. The HipSIT was greater in males than females (p < 0.001) and greater in the dominant than non-dominant limb (p = 0.03).</p><p><strong>Conclusion: </strong>The findings support using HipSIT in the clinical assessment of CrossFit® participants. Clinicians can use the data as reference values for athletes who participate in CrossFit® and should consider the difference between sexes and lower limbs.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"19 11","pages":"1417-1425"},"PeriodicalIF":1.6,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dominant Arm Internal and External Rotation Strength is Related to Arm Pain in Youth Baseball Players.","authors":"Jeffrey Paskewitz, Fred Breidenbach, Philip Malloy, P Michael Eckrich, Ryan Zarzycki","doi":"10.26603/001c.124447","DOIUrl":"10.26603/001c.124447","url":null,"abstract":"<p><strong>Background and purpose: </strong>The prevalence of arm pain in youth baseball players is high with approximately half reporting arm pain during the season, and the number of ulnar collateral ligament reconstructions in youth baseball players is increasing. Few studies have examined the relationship between shoulder strength and passive range of motion (ROM) with arm pain (either shoulder or elbow pain) during throwing, especially in athletes in early adolescence. The purpose of this study was to determine the relationship between shoulder ROM and strength and the presence of arm pain during throwing in youth baseball players. It was hypothesized that less internal rotation (IR) ROM, less total rotational ROM, and lower IR and external rotation (ER) strength would be associated with arm pain.</p><p><strong>Study design: </strong>Observational cohort study.</p><p><strong>Methods: </strong>Sixty-five youth male baseball players between the ages of 12-15 were enrolled. Shoulder strength (ER, IR, ER/IR strength ratio, scaption) and passive ROM (ER, IR, flexion, horizontal adduction) were collected prior to the start of the spring 2021 baseball season. Players self-reported their arm pain frequency during throwing as never, rarely, sometimes, often, or always. The relationship between reported arm pain frequency during throwing and shoulder ROM and strength measurements was examined.</p><p><strong>Results: </strong>ER (ρ= -0.289, p=0.020) and IR strength (ρ= -0.262, p=0.035) were weakly and negatively correlated with reports of arm pain during throwing. No other clinical variables were associated with reports of arm pain (p ≥ 0.124).</p><p><strong>Conclusion: </strong>In youth baseball players, greater IR and ER strength were associated with less arm pain frequency during throwing, while ROM was not associated with arm pain frequency. Future research should explore these variables prospectively to determine if changes in ROM and strength are related to the development of arm pain in youth baseball players.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"19 11","pages":"1439-1446"},"PeriodicalIF":1.6,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Position- and Sex-Related Differences in Sagittal and Frontal Plane Concentric Isokinetic Hip Muscle Peak Torques and Agonist-Antagonist Ratios.","authors":"Lisa T Hoglund, Matthew C Schiffino, James E Freels, Isabella G Romano","doi":"10.26603/001c.124117","DOIUrl":"10.26603/001c.124117","url":null,"abstract":"<p><strong>Background: </strong>Hip muscle weakness is associated with many musculoskeletal conditions and athletic injuries. Isokinetic testing is often performed to measure a patient's strength or to assess treatment response. Patient sex and positioning during isokinetic strength testing may influence peak torque production and the agonist-antagonist peak torque ratios. However, different test positions are used clinically and in research to measure hip muscle strength. It is unknown how patient test position or sex impacts test results.</p><p><strong>Hypothesis/purpose: </strong>The purpose of this study was to determine whether concentric isokinetic peak torques of sagittal and frontal plane hip muscles differ when tested in recumbent versus standing positions and if results were impacted by patient sex.</p><p><strong>Study design: </strong>Cross-sectional observational.</p><p><strong>Methods: </strong>Forty healthy adults (20 male, 20 female) participated. Concentric isokinetic hip torques of the hip flexors, extensors, abductors, and adductors were measured with participants in two positions (recumbent versus standing; 60°/second angular velocity). Peak torque values were normalized by body mass and height. Data were analyzed with mixed-model ANOVAs (sex x position). Effect sizes were examined using partial eta squared.</p><p><strong>Results: </strong>No significant interactions or main effects for sex were found. Significant main effects for position were found for hip extensor and abductor peak torques and for hip flexor-extensor ratio. Hip extensor peak torque was greater when tested supine versus standing with a large effect size (<i>p</i>=.02, effect size =.14). Hip abductor peak torque was greater when tested sidelying versus standing with a medium effect size (<i>p</i>=.03, effect size =.12). Hip flexor-extensor agonist-antagonist ratio was greater when tested standing versus supine with a large effect size (<i>p</i><.001, effect size =.27).</p><p><strong>Conclusion: </strong>Hip extensor and abductor concentric isokinetic peak torques were greater when tested in recumbent versus standing positions. In contrast, hip flexor-extensor ratio was greater when tested in standing versus supine.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"19 11","pages":"1407-1416"},"PeriodicalIF":1.6,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurocognitive and Neuromuscular Rehabilitation Techniques after ACL Injury, Part 1: Optimizing Recovery in the Acute Post-Operative Phase- A Clinical Commentary.","authors":"Kevin E Wilk, Morgan Ivey, Zachary M Thomas, Lewis Lupowitz","doi":"10.26603/001c.124945","DOIUrl":"10.26603/001c.124945","url":null,"abstract":"<p><p>Anterior cruciate ligament (ACL) injury rates are on the rise, despite improved surgical techniques and prevention programs. While traditional rehabilitation emphasizes the restoration of motion, strength, and physical performance, emerging research highlights the importance of addressing neurocognitive deficits that can persist after injury. These deficits, including altered proprioception, impaired motor control and muscle recruitment, as well as heightened reliance on visual feedback, can significantly increase the risk of re-injury and impede return to sport. The purpose of this clinical commentary is to outline a proposed comprehensive approach to rehabilitation that challenges the neurocognitive system to optimize rehabilitation outcomes and reduce reinjury risk. Thus, this clinical commentary discusses the rationale for integrating neurocognitive training into all phases of ACLR rehabilitation, from initial injury to eight weeks post-surgery. It details the neurophysiological changes caused by ACL injury and presents evidence supporting the use of exercises that challenge visual attention, decision-making, and motor planning. A comprehensive rehabilitation framework incorporating both physical and neurocognitive components is proposed, aiming to improve long-term outcomes and reduce re-injury risk. Level of Evidence: 5.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"19 11","pages":"1373-1385"},"PeriodicalIF":1.6,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11540096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}