Wood Tyler A, Morrison Steven, Sosnoff Jacob J
Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, United States.
School of Physical Therapy and Athletic Training, Old Dominion University, Norfolk, VA, United States.
Front Med (Lausanne). 2019 Mar 27;6:53. doi: 10.3389/fmed.2019.00053. eCollection 2019.
Traumatic brain injuries (TBIs) are common and serious injuries to older adults. The majority of TBIs in older adults are sustained when the head impacts the ground or other surface during a fall. While several non-modifiable risk factors have been identified for fall-related TBIs in older adults, there still remains a dearth of knowledge surrounding modifiable risk factors. Thus, this significant knowledge gap warrants an investigation into research across disciplines. The sports medicine literature has examined several modifiable risk factors to prevent a mild form of TBI known as concussion. While this research has identified several risk factors, one particular risk factor may have potential implications to fall-related TBIs in older adults. The sports medicine literature has shown that decreased neck strength and slower neck muscle activation are significant predictors for sports-related concussion. Similarly, older adults experience age-related declines to neck muscle strength and muscle activation. Consequently, these age-related declines to the neck musculature may result in the inability of older adults to control their head during a fall, which results in greater impact forces being transmitted to the brain and increases the risk of TBI. This perspective article assesses the sports medicine literature related to the implications of neck strength and muscle activation in sports-related concussion, discusses age-related declines to neck strength and muscle activation, and highlights the potential impact of the neck musculature on fall-related TBIs in older adults.
创伤性脑损伤（TBI）在老年人中是常见且严重的损伤。老年人的大多数TBI是在跌倒时头部撞击地面或其他表面时发生的。虽然已经确定了一些与跌倒相关的TBI的不可改变的风险因素，但围绕可改变的风险因素仍然缺乏相关知识。因此，这一重大的知识空白值得跨学科进行研究调查。运动医学文献已经研究了几个可改变的风险因素，以预防一种称为脑震荡的轻度TBI形式。虽然这项研究已经确定了几个风险因素，但一个特定的风险因素可能对老年人与跌倒相关的TBI有潜在影响。运动医学文献表明，颈部力量下降和颈部肌肉激活较慢是与运动相关脑震荡的重要预测因素。同样，老年人会经历与年龄相关的颈部肌肉力量和肌肉激活能力下降。因此，这些与年龄相关的颈部肌肉组织衰退可能导致老年人在跌倒时无法控制头部，从而导致更大的冲击力传递到大脑，并增加TBI的风险。这篇观点文章评估了运动医学文献中与颈部力量和肌肉激活在运动相关脑震荡中的影响相关的内容，讨论了与年龄相关的颈部力量和肌肉激活能力下降，并强调了颈部肌肉组织对老年人与跌倒相关的TBI的潜在影响。
