Morris Amanda, Cassidy Benjamin, Pelo Ryan, Fino Nora F, Presson Angela P, Cushman Daniel M, Monson Nicholas E, Dibble Leland E, Fino Peter C
Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, United States.
Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States.
Front Sports Act Living. 2020 Oct 29;2:574848. doi: 10.3389/fspor.2020.574848. eCollection 2020.
Deficits in neuromuscular control are widely reported after mild traumatic brain injury (mTBI). These deficits are speculated to contribute to the increased rate of musculoskeletal injuries after mTBI. However, a concrete mechanistic connection between post-mTBI deficits and musculoskeletal injuries has yet to be established. While impairments in some domains of balance control have been linked to musculoskeletal injuries, reactive balance control has received little attention in the mTBI literature, despite the inherent demand of balance recovery in athletics. Our central hypothesis is that the high rate of musculoskeletal injuries after mTBI is in part due to impaired reactive balance control necessary for balance recovery. The purpose of this study is to (1) characterize reactive postural responses to recover balance in athletes with recent mTBI compared to healthy control subjects, (2) determine the extent to which reactive postural responses remain impaired in athletes with recent mTBI who have been cleared to return to play, and (3) determine the relationship between reactive postural responses and acute lower extremity musculoskeletal injuries in a general sample of healthy collegiate athletes. This two-phase study will take place at the University of Utah in coordination with the University of Utah Athletics Department. Phase 1 will evaluate student-athletes who have sustained mTBI and teammate-matched controls who meet all the inclusion criteria. The participants will be assessed at multiple time points along the return-to-play progress of the athlete with mTBI. The primary outcome will be measures of reactive postural response derived from wearable sensors during the Push and Release (P&R) test. In phase 2, student-athletes will undergo a baseline assessment of postural responses. Acute lower extremity musculoskeletal injuries for each participant will be prospectively tracked for 1 year from the date of first team activity. The primary outcomes will be the measures of reactive postural responses and the time from first team activity to lower extremity injury. Results from this study will further our understanding of changes in balance control, across all domains, after mTBI and identify the extent to which postural responses can be used to assess injury risk in collegiate athletes.
轻度创伤性脑损伤（mTBI）后神经肌肉控制缺陷的报道广泛存在。据推测，这些缺陷会导致mTBI后肌肉骨骼损伤发生率增加。然而，mTBI后缺陷与肌肉骨骼损伤之间具体的机制联系尚未确立。虽然平衡控制某些方面的损害与肌肉骨骼损伤有关，但尽管运动中平衡恢复有内在需求，但反应性平衡控制在mTBI文献中很少受到关注。我们的核心假设是，mTBI后肌肉骨骼损伤的高发生率部分归因于平衡恢复所需的反应性平衡控制受损。本研究的目的是：（1）与健康对照受试者相比，描述近期mTBI运动员恢复平衡的反应性姿势反应；（2）确定已获准恢复比赛的近期mTBI运动员反应性姿势反应仍受损的程度；（3）在健康大学生运动员的一般样本中确定反应性姿势反应与急性下肢肌肉骨骼损伤之间的关系。这项两阶段研究将在犹他大学与犹他大学体育系合作进行。第一阶段将评估遭受mTBI的学生运动员以及符合所有纳入标准的队友匹配对照。参与者将在mTBI运动员恢复比赛进程的多个时间点进行评估。主要结果将是在推挽（P&R）测试期间从可穿戴传感器获得的反应性姿势反应测量值。在第二阶段，学生运动员将接受姿势反应的基线评估。从首次团队活动之日起，对每位参与者的急性下肢肌肉骨骼损伤进行为期1年的前瞻性跟踪。主要结果将是反应性姿势反应测量值以及从首次团队活动到下肢损伤的时间。本研究结果将进一步加深我们对mTBI后所有领域平衡控制变化的理解，并确定姿势反应可用于评估大学生运动员损伤风险的程度。
