Context: Only 55% of the athletes return to competitive sports after an anterior cruciate ligament (ACL) injury. Athletes younger than 25 years who return to sports have a second injury rate of 23%. There may be a mismatch between rehabilitation contents and the demands an athlete faces after returning to sports. Current return-to-sports (RTS) tests utilize closed and predictable motor skills; however, demands on the field are different. Neurocognitive functions are essential to manage dynamic sport situations and may fluctuate after peripheral injuries. Most RTS and rehabilitation paradigms appear to lack this aspect, which might be linked to increased risk of second injury.Objective: This systematic and scoping review aims to map existing evidence about neurocognitive and neurophysiological functions in athletes, which could be linked to ACL injury in an integrated fashion and bring an extensive perspective to assessment and rehabilitation approaches.Data Sources: PubMed and Cochrane databases were searched to identify relevant studies published between 2005 and 2020 using the keywords ACL, brain, cortical, neuroplasticity, cognitive, cognition, neurocognition, and athletes.Study Selection: Studies investigating either neurocognitive or neurophysiological functions in athletes and linking these to ACL injury regardless of their design and technique were included.Study Design: Systematic review. Level of Evidence: Level 3.Data Extraction: The demographic, temporal, neurological, and behavioral data revealing possible injury-related aspects were extracted and summarized.Results: A total of 16 studies were included in this review. Deficits in different neurocognitive domains and changes in neurophysiological functions could be a predisposing risk factor for, or a consequence caused by, ACL injuries.Conclusion: Clinicians should view ACL injuries not only as a musculoskeletal but also as a neural lesion with neurocognitive and neurophysiological aspects. Rehabilitation and RTS paradigms should consider these changes for assessment and interventions after injury.
Physical inactivity has led to an increase in the prevalence of lifestyle-related chronic diseases on a global scale. There is a need for more awareness surrounding the preventive and curative role of a physically active lifestyle in healthcare. The prescription of physical activity in clinical care has been advocated worldwide through the ‘exercise is medicine’ (E=M) paradigm. However, E=M currently has no position in general routine hospital care, which is hypothesized to be due to attitudinal and practical barriers to implementation. This study aims to create an E=M tool to reduce practical barriers to enforcing E=M in hospital care. Firstly, this project will perform qualitative research to study the current implementation status of E=M in clinical care as well as its facilitators and barriers to implementation among clinicians and hospital managers. Secondly, an E=M tool towards application of active lifestyle interventions will be developed, based on a prediction model of individual determinants of physical activity behavior and local big data, which will result in a tailored advice for patients on motivation and physical activity. Thirdly, the feasibility of implementing the E=M-tool, as designed within this project, will be investigated with a process evaluation, conducting a pilot-study which will integrate the tool in routine care in at least four clinical departments in two Dutch hospitals. This project will give insight in the current implementation status of E=M and in factors that influence the actual E=M implementation. Secondly, an E=M tool will be designed providing a tailored E=M prescription for patients as part of clinical care. Thirdly, an implementation strategy will be developed for implementation of the E=M tool in clinical practice. This project envisages an extensive continuation of research on the implementation of E=M, supports the mutual decision making process of lifestyle referral of clinicians and will provide insights which can be used to assist in implementing physically active lifestyle prescription in the medical curriculum.
BACKGROUND: In typically developing children, participation in sports has been proven to be positively correlated to both physical and psychosocial health outcomes. In children and adolescents with a physical disability or chronic disease participation in both recreational and competitive sports is often reduced, while for this population an active lifestyle may be even more important in reaching optimal levels of physical and psychosocial health. Therefore, the aim of the Health in Adapted Youth Sports (HAYS) Study is to determine both negative and positive effects of sports on children and adolescents with a chronic disease or physical disability. METHODS: In this cross-sectional study differences will be compared in regards to physical and psychosocial health, cognitive functioning, school performance, daily physical activity and injuries between children and adolescents with a chronic disease or physical disability who participate in sports and those who do not. Children and adolescents, both ambulatory and wheelchair dependent, in the age of 10-19 years with a physical disability or chronic disease will be included. "Sports" is defined as participation in an organized sport at least two times a week for a duration of 3 months or more prior to the assessment. Parametric and non-parametric statistics will be used to determine the differences between the two groups. DISCUSSION: This study provides insight in the effects of sports participation in relation to health, psychosocial functioning, physical activity and school performance in children and adolescents (10-19 years) with a chronic disease or physical disability. Results will guide healthcare professionals working with these children to better guide this population in reaching optimal levels of health and physical activity levels.
Ballet en moderne dans zijn een vorm van topsport. De druk op dansers is enorm. Lange en intensieve werkdagen, veel reizen en verschillende werkplekken maken het lastig om lichaam en geest goed te verzorgen. Hierdoor liggen blessures en mentale klachten op de loer. Nederlandse dansgezelschappen willen meer aandacht gaan besteden aan preventieve maatregelen om fysieke en mentale problemen bij hun dansers te voorkomen. Het ontbreekt hen echter aan kennis en kunde om dit innovatieve vraagstuk op te kunnen pakken. Het Nationale Ballet en het Scapino Ballet hebben het lectoraat Performing Arts Medicine van Codarts (Hogeschool voor de Kunsten Rotterdam) benaderd om antwoord te krijgen op de vraag hoe dansers op de hoogste podia, op gezonde wijze, hun beste performance kunnen laten zien. Gezamenlijk is deze praktijkvraag omgevormd naar drie onderzoeksdoelstellingen: 1. Opstellen van meetinstrumenten om de fysieke en mentale gezondheid van dansers te screenen en te monitoren; 2. Ontwerpen van een web-based systeem dat automatisch en real-time informatie uit de ontwikkelde meetinstrumenten kan inlezen, analyseren en interpreteren; 3. Ontwikkelen van een Fit to Perform protocol dat aanbevelingen geeft ten aanzien van het verbeteren van de fysieke en mentale gesteldheid van de danser. Het consortium bestaat uit de volgende organisaties: - Praktijkgerichte onderzoeksinstellingen: Codarts Rotterdam en Hogeschool van Amsterdam; - Universiteiten: ErasmusMC, Technische Universiteit Eindhoven en Vrije Universiteit Amsterdam; - Praktijkinstellingen: Het Nationale Ballet en het Scapino Ballet; - Overige instellingen: het Nederlands Paramedisch Instituut (NPi) en het Nationale Centrum Performing Arts (NCPA). Bij de samenstelling van het consortium is gekozen voor een goede mix tussen praktijkorganisaties, onderzoeksinstituten en onderwijsinstellingen. Daarnaast is er sprake van cross-sectorale samenwerking doordat kennis vanuit de podiumkunsten, sport, gezondheidszorg, onderwijs en technologie met elkaar verbonden wordt.
