Examining the Role of Cognition in the Risk of Lower Extremity Musculoskeletal Injuries and Concussions Among Elite Athletes

Abstract

Risk factors for lower extremity musculoskeletal (LEMSK) injury and concussion have largely been examined in isolation. This thesis sought to elucidate the associations between cognition, concussion, and LEMSK injury. Cognition was measured by the Vienna Test System (VTS) and injuries (LEMSK and concussions) were documented prospectively among elite athletes. Study 1 (N = 58) assessed the test-retest reliability (9-21-month period) and temporal stability of the VTS. Across cognitive tests, reliability ranged from poor to good (0.34-0.83). Cognition significantly changed across time points, most notably in cognitive flexibility. Study 2 (N = 145) explored cognition and concussion history as risk factors of injury. Concussion history and slower reaction time on a working memory test significantly predicted LEMSK injury. Concussion history and cognition did not significantly predict concussion. Moreover, no cognitive measures mediated the relationships between concussion history and subsequent injury. Therefore, future research should explore alternative mechanisms that underly these associations.