AUTHOR=Chaaban Courtney R. , Turner Jeffrey A. , Padua Darin A. 

TITLE=Think outside the box: Incorporating secondary cognitive tasks into return to sport testing after ACL reconstruction

JOURNAL=Frontiers in Sports and Active Living

VOLUME=Volume 4 - 2022

YEAR=2023

URL=https://www.frontiersin.org/journals/sports-and-active-living/articles/10.3389/fspor.2022.1089882

DOI=10.3389/fspor.2022.1089882

ISSN=2624-9367

ABSTRACT=The optimal set of return to sport (RTS) tests after anterior cruciate ligament (ACL) injury and ACL reconstruction (ACLR) remains elusive. Many athletes fail RTS test batteries, do not RTS, or sustain secondary ACL injuries upon RTS. The purpose of this review is to summarize literature regarding functional RTS testing after ACLR and to encourage clinicians to have patients “think” (add a secondary cognitive task) outside the “box” (in reference to the box used during the drop vertical jump task) when performing functional RTS tests. We review important criteria for functional tests in RTS testing. Firstly, tests should replicate the sport-specific demands the athlete will encounter, such as performing a dual cognitive-motor task (e.g., attending to an opponent while performing a cutting maneuver). However, most functional RTS tests do not incorporate a secondary cognitive load. Secondly, tests should be measurable, both through the athlete’s ability to complete the task safely (biomechanical analyses) and efficiently (performance measures). We highlight and critically examine three examples of functional tests that are commonly used for RTS testing: the drop vertical jump, single-leg hop tests, and cutting tasks. We discuss how biomechanics and performance can be measured during these tasks, including the relationship these variables may have with injury. We then discuss how cognitive demands can be added to these tasks, and how these demands influence both biomechanics and performance. Lastly, we provide clinicians with practical recommendations on how to implement secondary cognitive tasks into functional testing and how to assess athletes’ biomechanics and performance