J Orthop Sports Phys Ther. 2019 Mar;49(3):202-208. doi: 10.2519/jospt.2019.8582. Epub 2019 Jan 15.
Sports-related concussion (SRC) occurs due to biomechanical forces to the head or neck that can result in pathophysiological changes in the brain. The musculature of the cervical spine has been identified as one potential factor in reducing SRC risk as well as for underlying sex differences in SRC rates. Recent research has demonstrated that linear and rotational head acceleration, as well as the magnitude of force upon impact, is influenced by cervical spine biomechanics. Increased neck strength and girth are associated with reduced linear and rotational head acceleration during impact. Past work has also shown that overall neck strength and girth are reduced in athletes with SRC. Additionally, differences in cervical spine biomechanics are hypothesized as a critical factor underlying sex differences in SRC rates. Specifically, compared to males, females tend to have less neck strength and girth, which are associated with increased linear and rotational head acceleration. Although our ability to detect SRC has greatly improved, our ability to prevent SRC from occurring and decrease the severity of clinical outcomes postinjury is limited. However, we suggest, along with others, that cervical spine biomechanics may be a modifiable factor in reducing SRC risk. In this commentary, we review the role of the cervical spine in reducing SRC risk, and how this risk differs by sex. We discuss clinical considerations for the examination of the cervical spine and the potential clinical relevance for SRC prevention. Additionally, we provide suggestions for future research examining cervical spine properties as modifiable factors in reducing SRC risk. J Orthop Sports Phys Ther 2019;49(3):202-208. Epub 15 Jan 2019. doi:10.2519/jospt.2019.8582.
运动相关性脑震荡（SRC）是由于头部或颈部的生物力学力引起的，可导致大脑的病理生理变化。颈椎的肌肉结构已被确定为降低 SRC 风险的一个潜在因素，也是 SRC 发生率存在潜在性别差异的原因之一。最近的研究表明，线性和旋转头部加速度以及撞击时的力的大小受到颈椎生物力学的影响。增加颈部力量和周长与撞击时线性和旋转头部加速度的降低有关。过去的工作还表明，患有 SRC 的运动员的整体颈部力量和周长减小。此外，颈椎生物力学的差异被假设为 SRC 发生率存在性别差异的关键因素。具体而言，与男性相比，女性的颈部力量和周长较小，这与线性和旋转头部加速度的增加有关。尽管我们检测 SRC 的能力有了很大提高，但我们预防 SRC 发生和降低受伤后临床结果严重程度的能力有限。但是，我们建议（与其他人一起），颈椎生物力学可能是降低 SRC 风险的一个可改变的因素。在本评论中，我们回顾了颈椎在降低 SRC 风险中的作用，以及这种风险如何因性别而异。我们讨论了颈椎检查的临床注意事项以及 SRC 预防的潜在临床相关性。此外，我们还为未来研究提供了建议，这些研究将颈椎特性作为降低 SRC 风险的可改变因素。《美国骨科运动医学杂志》2019 年；49(3):202-208。2019 年 1 月 15 日在线发表。doi:10.2519/jospt.2019.8582。
