Treating ACL Injury–Associated Neuroplasticity: A Neurocognitive-Motor Rehabilitation Case Study.

BACKGROUND: This case study explores the effect of a tailored neurocognitive-motor rehabilitation program in a patient with multiple anterior cruciate ligament (ACL) injuries. ACL injuries are known for their high recurrence rates and significant impact on an individual's functional capacity and overall quality of life. Incorporating neurocognitive elements into rehabilitation may enhance recovery outcomes by addressing the neural adaptations associated with injury. CASE PRESENTATION: A 24-year-old male with recurrent ACL injuries showed persistent instability, perceived as a sensation of the knee giving way, despite traditional rehabilitation. A key aspect was the use of computer-based cognitive tests to guide neurocognitive exercises. An augmented rehabilitation program incorporating motor learning principles and neurocognitive progressions was introduced. Functional performance on triple leg hops with and without a dual task was the main outcome. OUTCOME AND FOLLOW-UP: The patient showed improvements in neurocognitive hop tests, with a dual-task cost improvement of 9.3% on the injured side and 3.5% on the uninjured side. The Limb Symmetry Index remained above 90%. DISCUSSION: This case indicates that integrating a personalized neurocognitive element into rehabilitation may improve triple hops with and without a dual task. JOSPT Cases 2025;5(3):120-126. Epub 5 June 2025. doi:10.2519/josptcases.2025.0089 ABSTRACT FROM AUTHOR