University of Tennessee-Chattanooga.
United States Olympic Committee, Colorado Springs, CO.
J Athl Train. 2020 Jun 23;55(6):594-600. doi: 10.4085/1062-6050-0401.19.
Detection of subtle changes in brain sensorimotor processes may enable clinicians to identify athletes who would derive the greatest benefit from interventions designed to reduce the risk for future injury and progressive neurologic or musculoskeletal dysfunction.
To develop a generalizable statistical model for identifying athletes who possess subtle alterations in sensorimotor processes that may be due to previous concussion.
Cross-sectional study.
Residential Olympic Training Center sports medicine clinic.
A primary cohort of 35 elite athletes and a secondary cohort of 40 elite athletes who performed identical tests the preceding year.
INTERVENTION(S): Two upper extremity tests of visual-motor reaction time and 2 tests of whole-body reactive agility were administered. The whole-body tests required lateral or diagonal responses to virtual-reality targets, which provided measures of reaction time, speed, acceleration, and deceleration.
MAIN OUTCOME MEASURE(S): Sport-related concussion history, which was reported by 54% (n = 19) of the athletes in the primary cohort and 45% (n = 18) of the athletes in the secondary cohort.
Univariable analyses identified 12 strong predictors of sport-related concussion history, which we combined to create a composite metric with maximum predictive value. Composite lateral asymmetry for whole-body reactive movements and persisting effects of previous musculoskeletal injury yielded a logistic regression model with exceptionally good discrimination (area under the curve = 0.845) and calibration (predicted-observed probabilities within 7 subgroups: r = 0.959, P = .001). Application of the derived model to compatible data acquired from another cohort of elite athletes demonstrated very good discrimination (area under the curve = 0.772) and calibration (within 8 subgroups: r = 0.849, P = .008).
Asymmetry in whole-body reactive movement capabilities may be a manifestation of a subtle abnormality in the functional connectivity of brain networks that might be relevant to previously reported associations between sport-related concussion history and musculoskeletal injury occurrence.
检测大脑感觉运动过程中的细微变化，可能使临床医生能够识别出那些从旨在降低未来受伤风险和进行性神经或肌肉骨骼功能障碍风险的干预措施中获益最大的运动员。
开发一种可推广的统计模型，以识别出那些在感觉运动过程中存在细微变化的运动员，这些变化可能是由于之前的脑震荡引起的。
横断面研究。
奥运训练中心的运动医学诊所。
一个主要队列包括 35 名精英运动员，另一个次要队列包括 40 名在前一年进行了相同测试的精英运动员。
进行了两项上肢视觉运动反应时间测试和两项全身反应敏捷性测试。全身测试需要对虚拟现实目标进行横向或对角线反应，提供反应时间、速度、加速度和减速度的测量。
运动相关脑震荡史，主要队列中有 54%（n=19）的运动员和次要队列中有 45%（n=18）的运动员报告了该史。
单变量分析确定了 12 个与运动相关脑震荡史有强关联的预测因素，我们将其组合成一个具有最大预测价值的综合指标。全身反应运动的横向不对称性和先前肌肉骨骼损伤的持续影响，产生了一个具有极好区分度（曲线下面积=0.845）和校准度（7 个亚组内预测-观察概率：r=0.959，P=0.001）的逻辑回归模型。将该模型应用于来自另一批精英运动员的兼容数据，结果显示出非常好的区分度（曲线下面积=0.772）和校准度（8 个亚组内：r=0.849，P=0.008）。
全身反应运动能力的不对称性可能是大脑网络功能连接中细微异常的表现，这可能与之前报道的运动相关脑震荡史与肌肉骨骼损伤发生之间的关联有关。
