Abstract

Growing evidence implicates several neuropsychological factors in the mechanism of noncontact anterior cruciate ligament (ACL) sprains.1–6 Just before the joint loads is a short period of time when sensory integration and complex motor planning must accurately predict impending joint loads.7 Errors in judgment or unanticipated stimuli may cause a momentary loss of situational awareness or startle responses.6,8,9 If the brain's executive functioning is unable to successfully negotiate the rapidly changing environmental conditions, then the action-planning networks are disrupted and task uncertainty ensues. The subsequent loss of neuromuscular control and inability to optimally regulate knee-joint stiffness diminishes dynamic stability. This can lead to unconstrained columnar buckling, which is often associated with noncontact ACL injury pathomechanics.8,10,11 In this article, I briefly review anecdotal, theoretical, and clinical research evidence for the brain's role in maintaining joint stability and neuropsychological factors that may render individuals injury prone. Verf.-Referat