A - 51 Examining the Role of Cognition in Lower Extremity Musculoskeletal Injury and Concussion Risk in Elite Athletes

Recent evidence suggests a relationship between cognitive performance and the risk of lower extremity musculoskeletal (LEMSK) injury, and that concussion may also increase the risk of subsequent LEMSK injury, though these relationships have been largely examined in isolation. This study examined associations between pre-season cognitive performance and the risk of subsequent LEMSK injury and concussion among elite athletes. An observational study of elite/international-level athletes from a Canadian national sport institute. 146 athletes (female = 87) across six different sports completed pre-season cognitive testing (Vienna Test System) between 2018 and 2023. Subsequent LEMSK injuries and concussions during the year following pre-season cognitive testing were documented via an injury surveillance program. Pre-season cognitive performance was similar in athletes with (n = 24) and without (n = 122) a subsequent concussion, and those with (n = 100) and without (n = 46) a subsequent LEMSK (ps > 0.05). Athletes with both a subsequent LEMSK and concussion had slower baseline reaction time on a task of stress reactivity (n = 16; median RT = 0.74 s) compared to athletes with only a subsequent LEMSK (n = 84; median RT = 0.69 s; V = 900.5, p = 0.019). Concussion history was a significant predictor of both subsequent LEMSK (B = 0.94, p = 0.017) and the number of subsequent LEMSK (B = 1.23, p < 0.01). Faster RTs on inhibition tests were predictors of subsequent number of LEMSK, while controlling for concussion history (B = -10.21, p = 0.045; B = -10.60, p = 0.017). Identifying risk factors for LEMSK injuries and concussions is critical for preventing future injuries. These preliminary results suggest a relationship between baseline reaction time performance and combined subsequent LEMSK and concussion injury.