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Workshop #6

Neurocognitive capacities of athletes in complex environments. Implications for return to sports continuum after acute ankle sprains ?

Speaker 1: Alli Gokeler

Speaker 2: Daniel Büchel

Background & Relevance: Recently, the use of a complex systems theory in combination with the return to sports continuum has been proposed to establish a criteria based return to sports approach after lateral ankle sprain (LAS) injuries. Moreover, the need for further investigation for sport-specific testing was highlighted. An underrepresented aspect in the domain of sport specific testing, both in injury prevention as well as in rehabilitation, are the neurocognitve capacities of athletes. 

Athletes of team ball sports have to perceive essential information from the rapidly changing situation on the field and must then interpret this information correctly to select the most appropriate response. In other words, factors like reaction time, anticipation and decision making are some of the key characteristics of neurocognitiive function in light of prevention and rehabilitation. Low levels of basic neurocognitive function has been related to poor neuromuscular performance during landing tasks. Moreover, deficits in reaction time and processing speeds indicate a potential neurocognitive predisposition to lower extremity injury. In a frequent observed injury mechanism, the player is embedded in a playing situation where external factors such contact with a ball and position of team mates and opponents are involved. The attentional and environmental components of neuromuscular function are largely not addressed in current injury prevention and rehabilitation programs.

Components of current rehabilitation programs entail a combination of exercises to restore range of motion, increase muscle strength, postural control, endurance and improve neuromuscular function. Although the importance of these factors are acknowledged, there is a clear need for improvement in light of of the high risk for development of chronic ankle instability. 

Training of neurcognitive factors such as reaction time, information processing, sustained and specific task direction attention, anticipation all within a complex task environmental interaction are currently not widely used in rehabilitation. In this workshop an overview of the foundations of neurocognitive integration into clinical practice will be presented. Mechanisms and evidence of neurocognition will lay the foundation for the understanding of new perspectives for prevention and rehabilitation programs. This knowledge is then used to demonstrate how clinicians can embrace neurocognitive principles to reduce injury risk. Neurocognitive principles could also be considered for the development of future screening tests.

Learning Objective 1: Practical explanation of the brain mechanisms of perception: How we make sense of the world around us: Perception and the brain. Pattern recognition.

Learning Objective 2: Eevaluate the neurocognitive readiness of the athlete to return to sports after a lateral ankle sprain.

Learning Objective 3: After this workshop, participants will be able to implement principles of neurocognition for rehabilitation and/or prevention in their own clinical setting.