Nicholas Murray1, Emily Belson2, Brian Szekely3, Arthur Islas4, Daniel Cipriani5, Robert C Lynall6, Thomas A Buckley7, Douglas W Powell8, Barry Munkasy2. 1. School of Community Health Sciences, University of Nevada, Reno. 2. Waters School of Health Professions, Georgia Southern University, Statesboro. 3. Neuroscience Institute, University of Nevada, Reno. 4. School of Medicine, University of Nevada, Reno. 5. Doctor of Physical Therapy Program, West Coast University Center for Graduate Studies, Los Angeles, CA. 6. UGA Concussion Research Laboratory, University of Georgia, Athens. 7. Department of Kinesiology and Applied Physiology and Biomechanics and Movement Science Interdisciplinary Program, University of Delaware, Newark. 8. Exercise Neuroscience Research Laboratory, School of Health Studies, University of Memphis, TN.
Abstract
CONTEXT: Lower extremity musculoskeletal (LEMSK) injury may be more prevalent among those with a history of sport-related concussion (SRC). OBJECTIVE: To investigate the relationship between baseline postural control metrics and the LEMSK injury incidence in National Collegiate Athletic Association Division I student-athletes with a history of SRC. SETTING: National Collegiate Athletic Association Division I athletes. DESIGN: Cohort study. PATIENTS OR OTHER PARTICIPANTS: Of 84 total athletes (62 males), 42 had been previously diagnosed with an SRC, and 42 were matched controls based on age, sex, height, weight, and sport. MAIN OUTCOME MEASURE(S): During the preseason baseline evaluation, all participants performed 3 trials of eyes-open and eyes-closed upright quiet stance on a force platform. Medical charts were assessed for all the LEMSK injuries that occurred from preseason baseline to 1 year later. Center-of-pressure data in the anteroposterior and mediolateral directions were filtered before we calculated root mean square and mean excursion velocity; the complexity index was calculated from the unfiltered data. Factorial analysis-of-variance models were used to examine differences between groups and across conditions for root mean square; mean excursion velocity, complexity index, and tests of association to examine between-groups LEMSK differences; and logistic regression models to predict LEMSK. RESULTS: Concussion history and injury incidence were related in the SRC group (P = .043). The complexity index of the SRC group was lower with eyes closed (14.08 ± 0.63 versus 15.93 ± 0.52) and eyes open (10.25 ± 0.52 vs 11.80 ± 0.57) in the mediolateral direction than for the control participants (P < .05). Eyes-open root mean square in the mediolateral direction was greater for the SRC group (5.00 ± 0.28 mm) than the control group (4.10 ± 0.22 mm). Logistic regression models significantly predicted LEMSK only in control participants. CONCLUSIONS: These findings may suggest that LEMSK after SRC cannot be predicted from postural-control metrics at baseline.
CONTEXT: Lower extremity musculoskeletal (LEMSK) injury may be more prevalent among those with a history of sport-related concussion (SRC). OBJECTIVE: To investigate the relationship between baseline postural control metrics and the LEMSK injury incidence in National Collegiate Athletic Association Division I student-athletes with a history of SRC. SETTING: National Collegiate Athletic Association Division I athletes. DESIGN: Cohort study. PATIENTS OR OTHER PARTICIPANTS: Of 84 total athletes (62 males), 42 had been previously diagnosed with an SRC, and 42 were matched controls based on age, sex, height, weight, and sport. MAIN OUTCOME MEASURE(S): During the preseason baseline evaluation, all participants performed 3 trials of eyes-open and eyes-closed upright quiet stance on a force platform. Medical charts were assessed for all the LEMSK injuries that occurred from preseason baseline to 1 year later. Center-of-pressure data in the anteroposterior and mediolateral directions were filtered before we calculated root mean square and mean excursion velocity; the complexity index was calculated from the unfiltered data. Factorial analysis-of-variance models were used to examine differences between groups and across conditions for root mean square; mean excursion velocity, complexity index, and tests of association to examine between-groups LEMSK differences; and logistic regression models to predict LEMSK. RESULTS: Concussion history and injury incidence were related in the SRC group (P = .043). The complexity index of the SRC group was lower with eyes closed (14.08 ± 0.63 versus 15.93 ± 0.52) and eyes open (10.25 ± 0.52 vs 11.80 ± 0.57) in the mediolateral direction than for the control participants (P < .05). Eyes-open root mean square in the mediolateral direction was greater for the SRC group (5.00 ± 0.28 mm) than the control group (4.10 ± 0.22 mm). Logistic regression models significantly predicted LEMSK only in control participants. CONCLUSIONS: These findings may suggest that LEMSK after SRC cannot be predicted from postural-control metrics at baseline.
Entities:
Keywords:
center of pressure; mild traumatic brain injury; musculoskeletal injury; sport-related concussion
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