ArticleSports (Basel, Switzerland)2026
Neuromuscular and Neurocognitive Performance Associated with ACL Injury Risk in Youth Handball Players: A Prospective Cohort Study.
Article in Sports (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAnterior cruciate ligament (ACL) injuries in youth athletes are multifactorial, and the relative contributions of neuromuscular and neurocognitive variables remain inadequately comprehended.
methodsIn this prospective cohort study, 220 young handball players (104 girls and 116 boys; mean age 16.3 ± 1.4 years) participated in functional testing with the Back in Action system and baseline neurocognitive evaluation with the ImPACT battery. During the 24-month follow-up period, orthopedic specialists identified ACL damage, which was confirmed by magnetic resonance imaging (MRI). Univariable logistic regression and receiver operating characteristic (ROC) curve analyses were conducted to evaluate predictive capability.
resultsDuring the 24-month follow-up, 26 athletes sustained an ACL injury. Prolonged plyometric ground contact time was significantly associated with ACL injury occurrence in logistic regression analysis (
conclusionsNeuromuscular performance, specifically plyometric ground contact time and female sex, has predictive ability for ACL damage in youth handball players, while separate cognition assessments failed to independently differentiate injury risk. These findings support the use of objective neuromuscular evaluation in comprehensive injury prevention strategies in youth sport.
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