Concussion Increases Odds of Sustaining a Lower Extremity Musculoskeletal Injury After Return to Play Among Collegiate Athletes
Concussion Increases Odds of Sustaining a Lower Extremity Musculoskeletal Injury After Return to Play Among Collegiate Athletes
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DOI：
10.1177/0363546515622387
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发表时间：
2016-03-01
影响因子：
4.8
通讯作者：
Bell, David R.
中科院分区：
文献类型：
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作者：
Brooks, M. Alison;Peterson, Kaitlin;Bell, David R.
背景资料：先前的研究已经确定了脑震荡后大脑和运动功能的异常，这些异常持续到观察到的临床恢复之后。最近的研究表明，神经认知的细微缺陷可能会损害神经肌肉控制，从而可能增加脑震荡后下肢肌肉骨骼损伤的风险。目的：确定一组全国大学体育协会（NCAA）一级学院运动员在脑震荡后恢复比赛后90天内持续急性下肢肌肉骨骼损伤的几率。证据等级，3.方法：本研究包括75名运动员（58名男性; 17名女性）中的87例脑震荡，这些运动员参加了2011年至2014年在一个机构参加的NCAA I级足球，足球，曲棍球，垒球，篮球，摔跤或排球。对每例脑震荡患者恢复比赛后的90天内进行急性非接触性下肢肌肉骨骼损伤检查。恢复游戏后的每个90天时间段与最多3个对照组的相同90天时间段相匹配。对照组运动员没有脑震荡的历史，在过去的一年中被匹配到脑震荡运动员的运动队/性别，游戏，和位置。共182名对照（136名男性; 46名女性）90天期间进行了审查的急性损伤。条件Logistic回归被用来评估脑震荡和随后的急性下肢肌肉骨骼损伤的风险之间的关联。结果：急性下肢肌肉骨骼损伤的发病率较高，最近脑震荡的运动员（15/87; 17%）与匹配的对照组（17/182; 9%）相比。在恢复比赛后的90天内，脑震荡运动员的急性下肢肌肉骨骼损伤的几率是对照组的2.48倍（比值比，2.48; 95%CI，1.04-5.91; P = 0.04）。脑震荡的运动员比他们的非脑震荡队友在返回比赛后持续急性下肢肌肉骨骼损伤的几率增加。研究结果表明，在急性损伤阶段之后，可能需要进一步研究神经认知和运动控制缺陷，以降低后续损伤的风险。
Background: Previous studies have identified abnormalities in brain and motor functioning after concussion that persist well beyond observed clinical recovery. Recent work suggests subtle deficits in neurocognition may impair neuromuscular control and thus potentially increase risk of lower extremity musculoskeletal injury after concussion.Purpose: To determine the odds of sustaining an acute lower extremity musculoskeletal injury during the 90-day period after return to play from concussion in a cohort of National Collegiate Athletic Association (NCAA) Division I collegiate athletes.Study Design: Cohort study; Level of evidence, 3.Methods: Included in this study were 87 cases of concussion among 75 athletes (58 men; 17 women) participating in NCAA Division I football, soccer, hockey, softball, basketball, wrestling, or volleyball at a single institution from 2011 to 2014. The 90-day period after return to play for each case of concussion was reviewed for acute noncontact lower extremity musculoskeletal injury. Each 90-day period after return to play was matched to the same 90-day period in up to 3 controls. Control athletes without a history of concussion in the previous year were matched to concussed athletes by sport team/sex, games played, and position. A total of 182 control (136 men; 46 women) 90-day periods were reviewed for acute injury. Conditional logistic regression was used to assess the association between concussion and subsequent risk of acute lower extremity musculoskeletal injury.Results: The incidence of acute lower extremity musculoskeletal injury was higher among recently concussed athletes (15/87; 17%) compared with matched controls (17/182; 9%). The odds of sustaining an acute lower extremity musculoskeletal injury during the 90-day period after return to play were 2.48 times higher in concussed athletes than controls during the same 90-day period (odds ratio, 2.48; 95% CI, 1.04-5.91; P = .04).Conclusion: Concussed athletes have increased odds of sustaining an acute lower extremity musculoskeletal injury after return to play than their nonconcussed teammates. The study results suggest further investigation of neurocognitive and motor control deficits may be warranted beyond the acute injury phase to decrease risk for subsequent injury.