Lower Kinetic Chain, Meet the Thinking Brain: A Scoping Review of Cognitive Function and Lower Extremity Injury Risk.
Michaela A Reyes, Mark O Probasco, Trina N Worby and 3 others
PMID 35949381WHAT IT FOUND
Adding cognitive demands to physical tasks consistently worsened lower-limb mechanics, such as reducing knee flexion and increasing valgus.
Athletes with a history of concussion showed higher rates of subsequent lower-limb injury, even after symptoms resolved.
Key findings
01Dual-task paradigms consistently altered lower extremity mechanics towards riskier profiles, including decreased knee flexion and increased knee valgus.
02All twenty-two studies examining concussion history reported an increased risk of lower extremity injury, with risk lasting far beyond symptom resolution.
03Lower baseline cognitive function was associated with altered mechanics and injury risk in six of seven studies using ImPACT or other cognitive tests.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The review included a mix of study designs (cohort, cross-sectional, quasi-experimental), limiting the ability to draw causal conclusions. Definitions of 'cognition' varied across studies, making direct comparisons difficult. Many studies relied on surrogate measures of injury risk (biomechanics) rather than actual injury incidence. The literature is dominated by concussion studies, with fewer data on cognitively typical populations. No conclusions could be drawn regarding specific age groups, genders, or sport levels due to insufficient data.
Declared interests
Authors have nothing to declare.
The easy way to misread this
Do not assume that altered biomechanics during dual-task testing directly cause injury. The review notes that changes in mechanics may not lead to injury, and most evidence links concussion history to injury risk rather than proving a specific cognitive mechanism causes non-contact ACL tears.