Joint Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI, USA.
Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
Ann Biomed Eng. 2019 Oct;47(10):2057-2072. doi: 10.1007/s10439-018-02136-6. Epub 2018 Oct 22.
Studies of football athletes have implicated repetitive head impact exposure in the onset of cognitive and brain structural changes, even in the absence of diagnosed concussion. Those studies imply accumulating damage from successive head impacts reduces tolerance and increases risk for concussion. Support for this premise is that biomechanics of head impacts resulting in concussion are often not remarkable when compared to impacts sustained by athletes without diagnosed concussion. Accordingly, this analysis quantified repetitive head impact exposure in a cohort of 50 concussed NCAA Division I FBS college football athletes compared to controls that were matched for team and position group. The analysis quantified the number of head impacts and risk weighted exposure both on the day of injury and for the season to the date of injury. 43% of concussed athletes had the most severe head impact exposure on the day of injury compared to their matched control group and 46% of concussed athletes had the most severe head impact exposure for the season to the date of injury compared to their matched control group. When accounting for date of injury or season to date of injury, 72% of all concussed athletes had the most or second most severe head impact exposure compared to their matched control group. These trends associating cumulative head impact exposure with concussion onset were stronger for athletes that participated in a greater number of contact activities. For example, 77% of athletes that participated in ten or more days of contact activities had greater head impact exposure than their matched control group. This unique analysis provided further evidence for the role of repetitive head impact exposure as a predisposing factor for the onset of concussion. The clinical implication of these findings supports contemporary trends of limiting head impact exposure for college football athletes during practice activities in an effort to also reduce risk of concussive injury.
研究表明，足球运动员重复性头部撞击暴露与认知和大脑结构变化的发生有关，即使没有诊断出脑震荡也是如此。这些研究表明，连续头部撞击造成的累积损伤会降低耐受性并增加脑震荡的风险。支持这一前提的依据是，与没有诊断出脑震荡的运动员所承受的撞击相比，导致脑震荡的头部撞击的生物力学通常并不显著。因此，本分析对 50 名患有脑震荡的 NCAA 一级 FBS 大学橄榄球运动员队列与按球队和位置组匹配的对照组进行了重复性头部撞击暴露的量化分析。该分析量化了受伤当天以及整个赛季到受伤日的头部撞击次数和风险加权暴露。与对照组相比，43%的脑震荡运动员在受伤当天的头部撞击暴露最严重，46%的脑震荡运动员在整个赛季到受伤日的头部撞击暴露最严重。当考虑到受伤日期或整个赛季到受伤日的日期时，72%的所有脑震荡运动员与对照组相比，他们的头部撞击暴露最严重或第二严重。与累积头部撞击暴露与脑震荡发病相关的这些趋势在参与更多接触活动的运动员中更为明显。例如，77%的参与了 10 天或更多接触活动的运动员的头部撞击暴露比他们的对照组更严重。这种独特的分析为重复性头部撞击暴露作为脑震荡发病的一个易患因素提供了进一步的证据。这些发现的临床意义支持了当代限制大学橄榄球运动员在练习活动中头部撞击暴露的趋势，以努力降低脑震荡受伤的风险。
