Development of a Biomechanically-Based Post-Concussion Return to Play Protocol for Gymnasts

项目摘要/摘要 在与运动和娱乐相关的活动中，体操是导致头部损伤的主要原因，排在第二位 在非接触性运动中，非致命性脑损伤急诊室就诊的最常见原因。 尽管如此，体操比赛中的回归赛制还鲜有人研究。作为一项运动，体操是 由六个项目组成：男子艺术、女子艺术、节奏、杂技、蹦床和翻滚，以及 运用各种技巧展示平衡性、力量和艺术性的健美操。女子艺术 体操是体操中最受欢迎的项目，被推荐用来发展力量 以及女青年运动员的协调性。然而，这项运动的身体需求往往会导致各种各样的 包括脑震荡在内的损伤和女性在体操项目中所占比例更高-- 相关伤害在医院接受治疗。从脑震荡中恢复的运动员重新融入运动中 一份有指导的返回比赛协议。现有的脑震荡后恢复比赛方案是为接触性运动开发的， 例如足球，可能与杂技运动无关，也没有生物力学证据 告知体操运动员独特的暴露档案。约500万美国人参加与体操相关的运动 在体操运动中，迫切需要了解头部复杂的加载环境，以 通知回程在这项运动中进行比赛。这项研究的目的是描述头部的运动学特征。 横跨女子艺术体操技能发展的生物力学后遗症 回到这项运动中的游戏规则。在目标1中，11个初级水平(11-13岁)和11个高级水平(13-15岁) 体操运动员将配备基于口罩的头部运动传感器。将收集生物力学数据并 在所有练习中进行量化，以确定头部加速的频率和幅度 在正常参与这项运动期间。一个小样本的运动员将用两个人完成一系列技能 渐进式安全改进，以评估安全改进对降低头部加速度的效果。在……里面 目标2，将使用混合方法来整合从文献中确定的回归比赛指南和来自 目标1.利益相关者将参与开发和完善生物力学信息的脑震荡后恢复 在女子艺术体操比赛中发挥礼仪。成果将包括议定书的特点和 供国家组织考虑采用的传播材料。这项R03小型先导性研究旨在 改变体操运动中脑震荡的管理模式，并将产生方法和关键数据 支持一项大规模研究，评估回归游戏方案在减少症状方面的有效性 脑震荡后的发作和恢复时间，同时评估这方面的最佳实施策略 环境。这种方法将提供一个框架，可以扩展到体操的其他学科 和杂技运动，以提高500多万参加杂技活动的运动员的安全。

Project Summary/Abstract Gymnastics is a leading cause of head injury among sports- and recreation-related activities and is the second most common cause of emergency room visits for non-fatal traumatic brain injury among non-contact sports. Despite this, return to play protocols in gymnastics have scarcely been researched. As a sport, gymnastics is composed of six disciplines: men’s artistic, women’s artistic, rhythmic, acrobatic, trampoline and tumbling, and aerobic gymnastics that utilize various skills showcasing balance, power, and artistry. Women’s artistic gymnastics is the most popular discipline of gymnastics and has been recommended for developing strength and coordination in female youth athletes. However, the physical demands of the sport often lead to a variety of injuries, including concussion, and females disproportionately represent a higher percentage of gymnastics- related injuries treated in hospitals. Athletes recovering from concussion are reintegrated back into sport using a guided return to play protocol. Existing post-concussion return to play protocols developed for contact sports, such as football, may not be relevant to acrobatic sports and are not grounded in biomechanical evidence informing the unique exposure profile of gymnasts. With ~ 5 million Americans participating in gymnastics-related activities, there is a critical need to understand the complex loading environment of the head in gymnastics to inform return to play protocols in the sport. The objective of this study is to characterize kinematics of the head across women’s artistic gymnastics skills for the development of a biomechanically-informed post-concussion return to play protocol in the sport. In Aim 1, 11 beginner-level (age 11-13) and 11 advanced-level (age 13-15) gymnasts will be fitted with mouthpiece-based head motion sensors. Biomechanical data will be collected and quantified during all practices to determine the frequency and magnitude of head accelerations experienced during normal participation of the sport. A sub-sample of athletes will complete a series of skills with two progressive safety modifications, to evaluate the effect of safety modifications on reducing head acceleration. In Aim 2, mixed methods will be used to integrate return to play guidelines identified from literature and data from Aim 1. Stakeholders will be engaged to develop and refine a biomechanically-informed post-concussion return to play protocol in women’s artistic gymnastics. Outcomes will include characteristics of the protocol and dissemination materials for national organizations to consider for adoption. This R03 small pilot study seeks to change the paradigm in which concussions are managed in gymnastics and will result in methods and key data to support a large-scale study evaluating the effectiveness of the return to play protocol on reducing symptomatic episodes and recovery time following concussion while assessing optimal implementation strategies in this environment. This approach will provide a framework that may be expanded to other disciplines of gymnastics and acrobatic sports to improve the safety of over 5 million athletes participating in acrobatic activities.