The effects of neurocognitive functional training on ACL injury risk during unanticipated sidestep cutting in male rugby football players

This study investigated the effects of neurocognitive functional training on the risk of ACL injury during unanticipated SSC. 

The study enrolled 19 male rugby players (21.9±2.2 years, 171.8±4.8 cm, 78.2±9.6 kg), who participated in regular rugby training and played in competitive games. All participants were instructed on the SSC technique and practiced simple reaction tasks to visual information during the first 6 weeks. At week 7, the participants were randomly assigned to neurocognitive functional training (9 players; NFC group) or control group (10 players). Training for the subsequent 8 weeks was similar to the initial training, but the NCF group added visual and auditory short-term memory tasks to the reaction tasks. The participants were examined with an unanticipated 90°-angled SSC on an artificial turf field before and after 14 weeks of training. Following the straight running, the participant changed direction toward same as green arrow signal and opposite to red arrow signal, which were randomly selected and turned on 2 meters before the cutting point. All trials were recorded using 3 digital video cameras, and the ACL injury risk was determined using the Cutting Movement Assessment Score (CMAS). The CMAS consists of 9 items assessing limbs and trunk position and posture associated with ACL injury risk, scored on a range of 0 (lowest risk) to 11 (highest risk). The average CMAS was calculated from 4 trials of turning right (SSC-R) and 4 of turning left (SSC-L). A repeated-measures two-way ANOVA (group × time) was used to compare the CMAS. Tukey-Kramer test was performed as post hoc tests.

Significant interaction effects were found for both CMAS of SSC-R and SSC-L (P0.05). In NCF group, the CMAS of SSC-R and SSC-L were significantly improved from 6.1±1.1 and 5.8±1.0 to 3.2±0.8 and 3.6±1.2, respectively (P0.05). On the other hand, those of SSC-R and SSC-L in the control group were not significantly improved after training (pre training:5.7±1.7, 5.6±1.9; post training: 5.3±1.1, 5.5±0.8).

 Neurocognitive functional training reduced the risk of ACL injury during SSC more effectively than the traditional movement instruction-based prevention training. 

Neurocognitive training is potentially more useful than traditional movement instructions or simple reaction tasks in preventing ACL injury during non-predictive SSC in rugby football. Prevention programs for ACL injuries should focus on neurocognitive function to enhance their effectiveness.