Practical Training Strategies to Apply Neuro-Mechanistic Motor Learning Principles to Facilitate Adaptations Towards Injury-Resistant Movement in Youth

Abstract

Youth may be particularly responsive to motor learning training strategies that support injury-resistant movement mechanics in youth for prevention programs that reduce injury risk, injury rehabilitation, exercise performance, and play more generally (Optimizing Performance Through Intrinsic Motivation and Attention for Learning Prevention Rehabilitation Exercise Play; OPTIMAL PREP) One purpose of the present manuscript was to provide clinical applications and tangible examples of how to implement the proposed techniques derived from OPTIMAL theory into PREP strategies for youth. A secondary purpose was to review recent advances in technology that support the clinical application of OPTIMAL PREP strategies without extensive resources/programming knowledge to promote evidence-driven tools that will support practitioner feedback delivery. The majority of examples provided are within the context of anterior cruciate ligament (ACL) injury rehabilitation, but we emphasize the potential for OPTIMAL PREP strategies to be applied to a range of populations and training scenarios that will promote injury resistance and keep youth active and healthy.

Can We Capitalize on Central Nervous System Plasticity in Young Athletes to Inoculate Against Injury?

“…Further, emergent data of direct CNS dysfunction related to ACL injury (specifically within the brain and spinal cord) has proliferated and generally fall into one of three categories in order of most empirical evidence: (1) CNS alterations following ACLR (2) CNS alterations that are associated with high ACL injury-risk biomechanics (e.g., aberrant frontal plane biomechanics) and (3) CNS dysfunction identified prior to future ACL injury. While a scoping review of these three topics are outside the aims of this report (see Neto et al [122] for such a review), we briefly describe each below to provide the foundation that supports the application of OPTIMAL PREP training strategies [34,36].…”

“…Specifically, the robust behavioral literature supporting the OPTI-MAL theory "pillars" of motor learning, as well as the theorized neural mechanisms of each principle, could potentially be used to uniquely target the neuroplasticity surrounding ACL injury [36]. Further literature provides more tangible examples of how OPTIMAL PREP strategies, such as "augmented" neuromuscular training [16][17][18] could be used to promote injury resistance [34].…”

“…Specifically, both patient populations demonstrated increased activity in various occipital-parietal regions compared to controls when completing their respective sensorimotorbased tasks [63,165]. OPTIMAL PREP strategies provide limitless potential for practitioners to apply techniques that target the aforementioned neural alterations [34]. For example, a clinician could aim to reweight their patients' brain activity in favor of sensorimotor activation using an external focus of attention [36].…”

Editorial

“…Practitioners working with youth should look to develop robust athletes who are physically well prepared to tolerate the demands of sport. In this special edition Diekfuss et al provide two review articles that highlight the opportunity to capitalize on high levels of neuroplasticity in youth to promote motor learning and develop injury-resistant athletes [1,2]. Diekfuss et al expand further to present a framework and examples for practitioners working with youth athletes [1]; Optimizing Performance Through Intrinsic Motivation And Learning Prevention Rehabilitation Exercise Play (OPTI-MAL PREP) [2].…”

“…In this special edition Diekfuss et al provide two review articles that highlight the opportunity to capitalize on high levels of neuroplasticity in youth to promote motor learning and develop injury-resistant athletes [1,2]. Diekfuss et al expand further to present a framework and examples for practitioners working with youth athletes [1]; Optimizing Performance Through Intrinsic Motivation And Learning Prevention Rehabilitation Exercise Play (OPTI-MAL PREP) [2]. Empirical work by Read et al provides evidence of the adaptability of movement control in young athletes in response to a short-term neuromuscular training program [8], while further work by Sommerfield et al examines the effects of a school-based injury prevention program on injury incidence in young females [9].…”