A common injury in athletes is an anterior cruciate ligament (ACL) rupture, necessitating a surgical reconstruction to restore knee stability. Although ACL reconstruction is followed by an intensive rehabilitation period, with an average duration of 12 months before return to sport (RTS), the reinjury rate is extremely high (1/4). The inability of current RTS screening tools to identify athletes at risk for re-rupture contributes to this clinical problem.

Previous research showed that increased activity in the prefrontal cortex is associated with premature movement quality. Giving the fact that ACLR patients often show aberrant movement quality after a traditional internally oriented rehabilitation, and since this has been identified as risk factor for (re)injury, it is striking that the possible relationship between brain activity and kinematics has never been studied before in relation to (re)injuries. In Virtual Reality (VR), a sport-specific experience can be created in which the patient’s attention is directed to the environment, forcing the body to rely on automatic motor control. Preliminary evidence indicates that the biomechanical risk profile for ACL (re)injury is more provoked during VR guided screening. Therefore, the aim of this study is to examine the relationship between brain activity and movement quality and, by implementing VR during RTS screening after ACLR, investigate the risk profile for (re)injury based on brain activity and biomechanics.