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

为体操运动员开发基于生物力学的脑震荡后恢复比赛方案

• 批准号: 10194706
• 负责人: Jillian Elizabeth Urban
• 金额: $ 7.38万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10194706
• 关键词: Acceleration; Address; Adoption; Aerobic; Affect; Age; American; Area; Back; Biomechanics; Brain Concussion; Characteristics; Code; Communities; Complex; Consensus; Craniocerebral Trauma; Custom; Data; Development; Discipline; Emergency department visit; Environment; Equilibrium; Event; Exposure to; Feedback; Female; Frequencies; Goals; Guidelines; Gymnastics; Head; Height; Hospitals; Hybrids; Injury; Investigation; Knowledge; Lead; Leadership; Literature; Manufactured Baseball; Manufactured football; Methods; Modeling; Modification; Monitor; Outcome; Participant; Periodicity; Pilot Projects; Play; Positioning Attribute; Process; Protocols documentation; Recovery; Recreation; Research; Research Project Grants; Rotation; Safety; Sampling; Series; Severities; Sports; Stomach; Strategic Planning; Surface; Testing; Time; Traumatic Brain Injury; United States; Weight; Woman; Work; Youth; base; contact sports; design; effectiveness evaluation; experience; falls; foot; implementation strategy; improved; instrument; kinematics; men; motion sensor; novel; skill acquisition; skills

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.

项目摘要/摘要 体操是体育和娱乐相关活动中头部受伤的主要原因，是第二个 急诊室访问非致命性脑损伤的最常见原因。 尽管如此，几乎没有研究重返体操协议。作为一项运动，体操是 由六个学科组成：男性艺术，女性艺术，有节奏，杂技，蹦床和翻滚，以及 使用各种技能展示平衡，力量和艺术性的有氧体操。女性艺术 体操是最受欢迎的体操学科，已被推荐用于发展力量 和女性青年运动员的协调。但是，这项运动的身体需求通常会导致多种 受伤，包括咨询和女性的伤害不成比例地代表了体操的比例更高 - 在医院治疗的相关伤害。从咨询中康复的运动员将重新融入 指导返回播放协议。现有的脑后返回播放协议为接触体育开发的协议， 例如足球，可能与杂技运动无关，并且没有基于生物力学证据 告知体操运动员的独特曝光概况。约有500万美国人参加与体操有关的 活动，迫切需要了解体操中的头部复杂的负载环境 告知这项运动中的播放协议。这项研究的目的是表征头部的运动学 在女性的艺术体操技能中 返回这项运动的播放协议。在AIM 1，11个初学者级别（11-13岁）和11个高级级别（13-15岁） 体操运动员将配备基于喉舌的头部运动传感器。将收集生物力学数据，并 在所有实践中量化以确定经历的头部加速度的频率和幅度 在这项运动的正常参与期间。运动员的子样本将完成一系列技能 进行性安全修改，以评估安全修改对减少头部加速度的影响。在 AIM 2，混合方法将用于整合从文献和数据中确定的数据的播放指南 AIM 1。利益相关者将参与开发和完善生物力学知名后的脑震荡回报 扮演女性艺术体操协议。结果将包括协议的特征和 国家组织的传播材料供采用。这项R03小型飞行员研究试图 更改在体操中管理咨询的范式，并将导致方法和关键数据 支持一项大规模研究，以评估降低有症状的播放方案的有效性 咨询后的情节和恢复时间，同时评估最佳实施策略 环境。这种方法将提供一个可以扩展到其他体操学科的框架 和杂技运动，以提高参加杂技活动的超过500万运动员的安全。