Can We Capitalize on Central Nervous System Plasticity in Young Athletes to Inoculate Against Injury?
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REVIEW ARTICLE
Can We Capitalize on Central Nervous System Plasticity in Young Athletes to Inoculate Against Injury? Jed A. Diekfuss1 · Jennifer A. Hogg2 · Dustin R. Grooms3,4,5 · Alexis B. Slutsky‑Ganesh6 · Harjiv Singh7 · Scott Bonnette1 · Manish Anand1 · Gary B. Wilkerson2 · Gregory D. Myer1,8,9 Received: 20 May 2020 / Accepted: 31 August 2020 © Beijing Sport University 2020
Abstract There are numerous physical, social, and psychological benefits of exercise, sport and play for youth athletes. However, dynamic activities come with a risk of injury that has yet to be abated, warranting novel therapeutics to promote injuryresistance and to keep an active lifestyle throughout the lifespan. The purpose of the present manuscript was to summarize the extant literature and potential connecting framework regarding youth brain development and neuroplasticity associated with musculoskeletal injury. This review provides the foundation for our proposed framework that utilizes the OPTIMAL (Optimizing Performance Through Intrinsic Motivation and Attention for Learning) theory of motor learning to elicit desirable biomechanical adaptations to support injury prevention (injury risk reduction), rehabilitation strategies, and exercise performance for youth physical activity and play across all facets of sport (Prevention Rehabilitation Exercise Play; PREP). We conclude that both young male and females are ripe for OPTIMAL PREP strategies that promote desirable movement mechanics by leveraging a unique time window for which their heightened state of central nervous system plasticity is capable of enhanced adaptation through novel therapeutic interventions. Keywords Musculoskeletal · Motor learning · Neuroplasticity · Development
The Problem: Anterior Cruciate Ligament Injuries in Youth Sustaining an injury to the anterior cruciate ligament (ACL) can be physically, emotionally, and financially traumatic for a youth athlete, including potential premature closure to an athletic career [48] and greater long-term risk of osteoarthritis and reduced quality of life [126, 135]. Following the * Jed A. Diekfuss [email protected] 1
The SPORT Center, Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 10001, Cincinnati, OH 45229, USA
Department of Health and Human Performance, The University of Tennessee Chattanooga, Chattanooga, TN, USA
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Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, USA Division of Athletic Training, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens, OH, USA
initial injury (i.e., primary), reports of subsequent ACL rerupture or contralateral ACL injury (i.e., secondary) within five years are as high as 23%, with youth athletes under the age of 25 being predominantly susceptible [3, 158]. Even when loss of function is restored and secondary injury is avoided, recent evidence indicates that successful return to pre-injury level of activi
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