将神经认知策略整合至前交叉韧带重建术后康复：一项面向临床实践的叙述性综述
简介
前交叉韧带重建（ACLR）虽能可靠恢复膝关节机械稳定性，但患者重返运动（RTS）的成功率仍不理想。许多运动员在满足传统力量和功能标准后，于认知负荷高、不可预测或情绪应激的运动场景中出现动作失控，凸显了以体能和时间节点为核心的康复方案的局限性。新证据表明，ACLR后存在持续的神经认知与感觉运动改变，影响感觉整合、运动控制策略及动作自动化。本文通过综述2015-…
英文摘要
Anterior cruciate ligament reconstruction (ACLR) reliably restores mechanical knee stability, yet successful return to sport (RTS) remains inconsistent. Many athletes meet conventional strength and functional criteria but demonstrate movement breakdowns when exposed to cognitively demanding, unpredictable, or emotionally salient sport environments, highlighting limitations of rehabilitation approaches focused primarily on physical capacity and time-based milestones. Growing evidence indicates that ACLR is associated with persistent neurocognitive and sensorimotor alterations that influence sensory integration, motor control strategies, and movement automaticity. This practice-oriented narrative review synthesizes clinically relevant literature on neurocognitive changes following ACLR and translates this evidence into a practical, phase-based framework for rehabilitation integration. A targeted search of PubMed, Scopus, and Web of Science (2015-2025) informed a qualitative synthesis emphasizing clinical relevance, feasibility, and safe implementation. Across studies, altered visual reliance, increased dual-task cost, reduced adaptability in complex environments, and threat-related movement behaviors commonly persist despite restoration of physical function. Observable clinical indicators may help identify individuals who benefit from a neurocognitive emphasis. An evidence-informed toolbox of neurocognitive training strategies, grounded in implicit motor learning and graded exposure principles, is proposed to complement conventional rehabilitation. Integrating neurocognitive demands across rehabilitation phases may enhance rehabilitation completeness and support safer, more durable RTS.