Athletes who wish to resume high-level activities after an injury to the anterior cruciate ligament (ACL) are often advised to undergo surgical reconstruction. Nevertheless, ACL reconstruction (ACLR) does not equate to normal function of the knee or reduced risk of subsequent injuries. In fact, recent evidence has shown that only around half of post-ACLR patients can expect to return to competitive level of sports. A rising concern is the high rate of second ACL injuries, particularly in young athletes, with up to 20% of those returning to sport in the first year from surgery experiencing a second ACL rupture. Aside from the increased risk of second injury, patients after ACLR have an increased risk of developing early onset of osteoarthritis. Given the recent findings, it is imperative that rehabilitation after ACLR is scrutinized so the second injury preventative strategies can be optimized. Unfortunately, current ACLR rehabilitation programs may not be optimally effective in addressing deficits related to the initial injury and the subsequent surgical intervention. Motor learning to (re-)acquire motor skills and neuroplastic capacities are not sufficiently incorporated during traditional rehabilitation, attesting to the high re-injury rates. The purpose of this article is to present novel clinically integrated motor learning principles to support neuroplasticity that can improve patient functional performance and reduce the risk of second ACL injury. The following key concepts to enhance rehabilitation and prepare the patient for re-integration to sports after an ACL injury that is as safe as possible are presented: (1) external focus of attention, (2) implicit learning, (3) differential learning, (4) self-controlled learning and contextual interference. The novel motor learning principles presented in this manuscript may optimize future rehabilitation programs to reduce second ACL injury risk and early development of osteoarthritis by targeting changes in neural networks.
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Context: Only 55% of the athletes return to competitive sports after an anterior cruciate ligament (ACL) injury. Athletes younger than 25 years who return to sports have a second injury rate of 23%. There may be a mismatch between rehabilitation contents and the demands an athlete faces after returning to sports. Current return-to-sports (RTS) tests utilize closed and predictable motor skills; however, demands on the field are different. Neurocognitive functions are essential to manage dynamic sport situations and may fluctuate after peripheral injuries. Most RTS and rehabilitation paradigms appear to lack this aspect, which might be linked to increased risk of second injury.Objective: This systematic and scoping review aims to map existing evidence about neurocognitive and neurophysiological functions in athletes, which could be linked to ACL injury in an integrated fashion and bring an extensive perspective to assessment and rehabilitation approaches.Data Sources: PubMed and Cochrane databases were searched to identify relevant studies published between 2005 and 2020 using the keywords ACL, brain, cortical, neuroplasticity, cognitive, cognition, neurocognition, and athletes.Study Selection: Studies investigating either neurocognitive or neurophysiological functions in athletes and linking these to ACL injury regardless of their design and technique were included.Study Design: Systematic review. Level of Evidence: Level 3.Data Extraction: The demographic, temporal, neurological, and behavioral data revealing possible injury-related aspects were extracted and summarized.Results: A total of 16 studies were included in this review. Deficits in different neurocognitive domains and changes in neurophysiological functions could be a predisposing risk factor for, or a consequence caused by, ACL injuries.Conclusion: Clinicians should view ACL injuries not only as a musculoskeletal but also as a neural lesion with neurocognitive and neurophysiological aspects. Rehabilitation and RTS paradigms should consider these changes for assessment and interventions after injury.
Modifiable (biomechanical and neuromuscular) anterior cruciate ligament (ACL) injury risk factors have been identified in laboratory settings. These risk factors were subsequently used in ACL injury prevention measures. Due to the lack of ecological validity, the use of on-field data in the ACL injury risk screening is increasingly advocated. Though, the kinematic differences between laboratory and on-field settings have never been investigated. The aim of the present study was to investigate the lower-limb kinematics of female footballers during agility movements performed both in laboratory and football field environments. Twenty-eight healthy young female talented football (soccer) players (14.9 ± 0.9 years) participated. Lower-limb joint kinematics was collected through wearable inertial sensors (Xsens Link) in three conditions: (1) laboratory setting during unanticipated sidestep cutting at 40-50°; on the football pitch (2) football-specific exercises (F-EX) and (3) football games (F-GAME). A hierarchical two-level random effect model in Statistical Parametric Mapping was used to compare joint kinematics among the conditions. Waveform consistency was investigated through Pearson's correlation coefficient and standardized z-score vector. In-lab kinematics differed from the on-field ones, while the latter were similar in overall shape and peaks. Lower sagittal plane range of motion, greater ankle eversion, and pelvic rotation were found for on-field kinematics (p < 0.044). The largest differences were found during landing and weight acceptance. The biomechanical differences between lab and field settings suggest the application of context-related adaptations in female footballers and have implications in ACL injury prevention strategies. Highlights: Talented youth female football players showed kinematical differences between the lab condition and the on-field ones, thus adopting a context-related motor strategy. Lower sagittal plane range of motion, greater ankle eversion, and pelvic rotation were found on the field. Such differences pertain to the ACL injury mechanism and prevention strategies. Preventative training should support the adoption of non-linear motor learning to stimulate greater self-organization and adaptability. It is recommended to test football players in an ecological environment to improve subsequent primary ACL injury prevention programmes.
In dit project verricht het lectoraat Familiebedrijven van Hogeschool Windesheim samen met de Hogeschool Utrecht, Hogeschool van Amsterdam, CUMELA, de Jong & Laan en MKB familiebedrijven praktijkgericht onderzoek naar financiering en besluitvorming bij MKB familiebedrijven. Nu banken vanwege de economische crisis terughoudender zijn geworden in kredietverlening en hun financieringseisen hebben verzwaard, zijn meer bedrijven aangewezen op eigen middelen en familiekapitaal. Vormen van zelf-financiering worden steeds belangrijker om groei en continuïteit van MKB familiebedrijven te waarborgen. Met name bij de overdracht van kapitaalintensieve MKB familiebedrijven worden complexe financieringsconstructies bedacht om de overname mogelijk te maken. Vaak wordt hierbij onvoldoende nagedacht over het onderscheid tussen de verschillende rollen die familieleden kunnen hebben als ze met hun vermogen in het bedrijf zitten (eigenaar of andere vermogensverschaffer, familielid, directielid, werknemer). Hierdoor kan onduidelijkheid ontstaan over onderwerpen zoals besluitvorming, rendement op vermogen, zeggenschap en beloningsstructuren, waardoor op termijn conflicten kunnen ontstaan. Daarnaast kan de besturing van ondernemingen door de verschillende belangen van vermogensverschaffers in negatieve zin worden beïnvloed en kan dit (op termijn) de continuïteit, wendbaarheid en groei van ondernemingen in gevaar brengen. Zowel in de praktijk als in het onderzoek ontbreekt het aan kennis over hoe met deze problematiek kan worden omgegaan. Dit project heeft daarom tot doel om samen met de projectpartners nieuwe kennis te ontwikkelen rond zelf-financiering en besluitvorming in MKB familiebedrijven. Door middel van ontwerpgericht praktijkonderzoek wordt bestaande en nieuwe kennis over de rol van zelf-financiering en de positie van eigenaren omgezet in oplossingsrichtingen ter verbetering van de besluitvorming in MKB familiebedrijven. Door het monitoren van de uitgevoerde interventies zal worden vastgesteld of de oplossingsrichtingen in de praktijk werken. De kennis die uit dit project voortkomt beoogt daarmee het handelingsvermogen van eigenaren en directieleden te vergroten en zelf-financiering als mogelijke financieringsbron effectiever te maken.
The utilization of drones in various industries, such as agriculture, infrastructure inspection, and surveillance, has significantly increased in recent years. However, navigating low-altitude environments poses a challenge due to potential collisions with “unseen” obstacles like power lines and poles, leading to safety concerns and equipment damage. Traditional obstacle avoidance systems often struggle with detecting thin and transparent obstacles, making them ill-suited for scenarios involving power lines, which are essential yet difficult to perceive visually. Together with partners that are active in logistics and safety and security domains, this project proposal aims at conducting feasibility study on advanced obstacle detection and avoidance system for low-flying drones. To that end, the main research question is, “How can AI-enabled, robust and module invisible obstacle avoidance technology can be developed for low-flying drones? During this feasibility study, cutting-edge sensor technologies, such as LiDAR, radar, camera and advanced machine learning algorithms will be investigated to what extent they can be used be to accurately detect “Not easily seen” obstacles in real-time. The successful conclusion of this project will lead to a bigger project that aims to contribute to the advancement of drone safety and operational capabilities in low-altitude environments, opening new possibilities for applications in industries where low-flying drones and obstacle avoidance are critical.
This project develops a European network for transdisciplinary innovation in artistic engagement as a catalyst for societal transformation, focusing on immersive art. It responds to the professionals in the field’s call for research into immersive art’s unique capacity to ‘move’ people through its multisensory, technosocial qualities towards collective change. The project brings together experts leading state-of-the-art research and practice in related fields with an aim to develop trajectories for artistic, methodological, and conceptual innovation for societal transformation. The nascent field of immersive art, including its potential impact on society, has been identified as a priority research area on all local-to-EU levels, but often suffers from the common (mis)perception as being technological spectacle prioritising entertainment values. Many practitioners create immersive art to enable novel forms of creative engagement to address societal issues and enact change, but have difficulty gaining recognition and support for this endeavour. A critical challenge is the lack of knowledge about how their predominantly sensuous and aesthetic experience actually lead to collective change, which remains unrecognised in the current systems of impact evaluation predicated on quantitative analysis. Recent psychological insights on awe as a profoundly transformative emotion signals a possibility to address this challenge, offering a new way to make sense of the transformational effect of directly interacting with such affective qualities of immersive art. In parallel, there is a renewed interest in the practice of cultural mediation, which brings together different stakeholders to facilitate negotiation towards collective change in diverse domains of civic life, often through creative engagements. Our project forms strategic grounds for transdisciplinary research at the intersection between these two developments. We bring together experts in immersive art, psychology, cultural mediation, digital humanities, and design across Europe to explore: How can awe-experiences be enacted in immersive art and be extended towards societal transformation?
