Purpose: This study investigated the evolution of neuromotor control during a typical short sport-specific rehabilitation program (SSR) in professional soccer players who had incurred a major lower-limb injury (n = 15, chondral and muscle injuries, ACL-reconstruction).Methods: All injured participants (n = 15) were in the on-field rehabilitation phase of their specific sport rehabilitation process, prior to return to play. An experimental group (EG, chondral and muscle injuries, ACL-reconstruction) followed a 3-week SSR-program composed of muscular and core strengthening (weightlifting, functional stability, explosivity and mobility exercises), running and cycling, neuromotor reprogramming, cognitive development and specific soccer on-field rehabilitation (acceleration, braking, cutting, dual-contact, high-speed-running, sprint, jump, drills with ball). Neuromotor control via analysis of movement kinematics, muscle activation and kinetic parameters was evaluated using a single-leg Countermovement-Jump, pre- and post- rehabilitation program. A control group (n = 22) of healthy soccer players of similar standards performed the same single-leg Countermovement-Jump to provide reference values regarding the level to be attained by the injured players for return to play.Results: In the experimental group, almost all kinetic analyses values progressed during the program and significantly for concentric Rate-of-Force-Development (p < 0.05), height jump (p < 0.001) and Reactive-Strength-Index Modified (p < 0.001) but remained lower than control group values for RSI-Mod (p < 0.05) and RFDconcentricLate (p < 0.001). Activation changed (p < 0.05) for all muscles except for rectus femoris and medial gastrocnemius in the pushing phase and rectus femoris during landing in the EG. Activation of all muscles decreased for EG, except for semitendinous which increased. Regarding kinematic analyses during the landing phase, there were a significant decrease in peak trunk flexion (p < 0.001) and lateroflexion (p < 0.001) and an increase in peak knee flexion (p < 0.001) for both legs. Trunk flexion (p < 0.001) and lateroflexion (p < 0.001) values were again higher for EG while knee flexion remained significantly lower than the CG (p < 0.001).Conclusion: The SSR generally improved neuromotor control suggesting that the present specific sport rehabilitation program, albeit of only three weeks duration, was effective in aiding elite footballers recover their neuromotor qualities although this was potentially insufficient to return to the values observed in healthy players.

Rupture of the anterior cruciate ligament (ACL) is common among soccer players. Although there are no strict recommendations for the return to sport, more and more practitioners are having their patients perform isokinetic and even composite tests. However, these tests have not yet been shown to be predictive of re-injury, and are not specific to professional footballers. Objectives: The “11 to Perf” is a test designed to help professional footballers return to sport after ACL reconstruction. Its originality lies in its integration of soccer practice with specific tests. The aim of this article is to present the “11 to Perf” evaluation method. Methods: A prospective cohort study was conducted at the Centre National du Football (FIFA center) in Clairefontaine, including professional footballers who have undergone anterior cruciate ligament surgery and rehabilitation. Tests include clinical assessments, jumping, agility, psychological and isokinetic tests and match simulation. Conclusions: The “11 to Perf” is a composite test designed to assess the return to sport of professional footballers after ACL reconstruction. Its predictive capacity for recurrence should be assessed in the future.

Background: Participation in soccer imposes high physical, mechanical, and cognitive demands. Recent evidence suggests that cognitive load, often overlooked in injury prevention, interacts with biomechanical factors and injury risk, resembling a dual-task paradigm where players must adapt motor responses while processing unpredictable game situations. This cross-sectional observational study examined how adding a dual-task during single-leg countermovement-jumps (SLCMJ) affects neuromotor control and performance in elite soccer players. Methods: Players performed SLCMJ on the injured leg while muscle activation, kinematics, and kinetics were measured, with and without a dual-task requiring color identification, via repeated-measures ANOVA; three injured groups (Chondropathy, n = 10, ACL, n = 15, Muscle Injury, n = 15) and a healthy control group (n = 22, followed the same protocol during final-rehabilitation stage. Results: Specific main outcomes were kinetics, kinematics, and EMG variables. Kinetic performances were significantly higher (p < 0.001, d > 0.6) with dual-task: eccentric rate-of-force-development, jump-height, reactive-strength-index-modified, and shorter for time-to-peak of ground-reaction-force (p < 0.05, d > 0.6). Muscle activation increased with dual-task in rectus femoris and biceps femoris during pushing (eccentric and concentric phases) (p < 0.01, d = 0.7) and for medial gastrocnemius during landing (p < 0.05, d = 0.7). Kinematic analyses showed greater pushing knee flexion, while pushing and landing trunk flexion was lower (p < 0.01, d > 0.8). Kinetic values in the three injured groups were lower than those of controls (p < 0.01, d > 0.8). Conclusions: Injured elite soccer players appeared disinhibited in dual-task conditions that improved SLCMJ performance but altered neuromotor control, underscoring the importance of a neurocognitive approach in return-to-play assessments to evaluate reinjury risk.

This study investigated the effects of lower-limb injuries on neuromotor capacities in a cohort of professional soccer players. Three injuries were assessed: chondropathy (CH, n = 10), thigh muscle-strain (MI, n = 15) and ACL-ruptures (ACLR, n = 15). Muscle activation, kinematics and kinetic parameters were recorded during a single-leg and double-leg Countermovement-jump. Values were compared to the dominant-leg of a healthy professional soccer players cohort (CT, n = 22). Results showed that ACLR was the most impactful injury particularly for kinetic variables: Reactive-Strength-Index-modified (p < 0.001, d = 1.1), jump height (p < 0.001, d = 1.1), rate-of-force development (p < 0.001, d = 1.0). CH was the second most impactful pathology (p < 0.001, d: 0.9–1.1) while results in MI were similar to CT (p > 0.05). Regarding kinematic variables, compensations were observable and dependent upon injury type. ACLR and CH were more impacted by compensation than MI using superior trunk-flexion and lateroflexion, lower knee-flexion in push-off and higher knee-flexion in landing. Concerning muscle activation, CT active more the semitendinous (p < 0.05, d = 0.6) and vastus-medialis (p < 0.05, d = 0.5). CH activated the most gastrocnemius-medium (p < 0.05, d = 0.6) and biceps-femoris for ACLR (p < 0.01, d = 0.7). Kinetics and muscle activation analysis during a vertical jump-test showed that CH and ACLR injuries were most impacted. It is useful to model the specific injury impact and manage rehabilitation and return-to-play processes.

L'objectif de cette thèse était double : i) objectiver les effets de la réathlétisation sur le contrôle neuromoteur de footballeurs de haut-niveau; ii) développer un modèle théorique prédictif de la survenue de blessure chez l'athlète sain. Le modèle expérimental du countermovement-jump (CMJ) a été utilisé pour tester les hypothèses spécifiques à chacune des 5 études réalisées. Les paramètres cinétiques, cinématiques et électromyographiques (EMG) du CMJ étaient calculés au moyen de plateforme de force, caméra rapide et électrodes de surface, respectivement. Trois pathologies des membres inférieurs ont été considérées: rupture du ligament croisé antérieur du genou, chondropathie de genou et lésions musculaires de la cuisse. Dans une 1ère étude, les résultats ont montré que les paramètres biomécaniques et EMG du CMJ de la jambe blessée et de la jambe non blessée étaient altérés dans tous les groupes pathologiques. Le programme SSR (specific sport rehabilitation) de trois semaines a permis d'améliorer significativement ces paramètres caractéristiques du contrôle neuromoteur. Dans une 2ème étude, le niveau de récupération fonctionnelle des footballeurs a été évalué par le biais de deux méthodes: la méthode LSI (limb symmetry index) et la méthode Norm-Values. Les résultats ont montré que la méthode Norm-Values était la plus discriminante. Dans une 3ème étude, la comparaison inter-groupes des paramètres biomécaniques et EMG a permis de mettre en évidence une « signature neuromotrice » spécifique à chaque pathologie. Dans une 4ème étude, les résultats ont montré que la superposition d'une tâche de prise d'information visuelle (tâche secondaire) avait un effet bénéfique sur les paramètres du CMJ (tâche primaire), probablement dû à une « défocalisation » de l'attention des athlètes blessés vers la tâche secondaire. Enfin, dans une dernière étude, le suivi longitudinal de joueurs sains au cours d'une saison a été réalisé avec pour objectif de développer un modèle théorique prédictif de blessure. Ce modèle, basé sur une méthode de machine learning a permis de mettre en évidence des tendances (non significatives) à la survenue de blessures en fonction des caractéristiques neuromotrices des joueurs. Globalement, l'ensemble de ces résultats contribue à l'amélioration des connaissances et des pratiques dans le domaine de la réathlétisation.