Neurocognitive function and musculoskeletal injury risk in sports:A systematic review

Objectives A variety of modifiable risk factors has been suggested to predict musculoskeletal injury in sports. Screening paradigms and exercise-based prevention programs, so far, frequently focused on physical parameters such as strength, balance or flexibility. However, less is known with regard to the impact of brain function. We investigated the relation between cognition and the occurrence of injury in athletes. Design Systematic review. Methods Database searches using Pubmed, Web of Science and Google Scholar returned nine cohort and case-control studies, which almost exclusively examined college athletes engaging in open skill sports. Methodological quality, rated by means of a modified Downs and Black checklist, was moderate (12/17 points). Results Seven out of the nine included studies suggested that lower-order cognitive function (i.e. visuomotor reaction time) is systematically associated with the occurrence of injury. No paper examined the impact of executive function. Conclusions Despite initial evidence pointing towards a potentially injury-predictive role of lower-order cognitive function, several issues including the use of more variable populations and outcomes remain to be addressed before definitive recommendations for clinicians can be made.