Evaluating the Head's Response to Impulsive Forces in Young Athletes

描述(申请人提供)：运动相关的脑震荡发生时，由外部物理力量引起的线性和角度头部运动在神经元水平上扰乱运动员的大脑功能。颈部较小、较弱的运动员，包括儿童和女性运动员，被认为有更高的脑震荡风险，因为他们的颈部较难对抗这些外部作用力，从而导致更剧烈的头部运动模式。运动员头部快速改变旋转方向时出现的双向鞭打运动，与类似量级的单向旋转模式相比，也可能增加与个人撞击相关的脑震荡风险。拟议的生物力学研究将追求以下具体目标：目的1)确定超声测量颈部肌肉大小和僵硬与头部在标准化脉冲力作用下的运动学反应之间的关系，跨越年龄和性别的频谱在每个解剖平面上；目的2)确定在运动模拟支撑任务中，商业碰撞传感系统是否能够预测双向和单向旋转模式，如高速运动学运动捕捉系统所确定的。与这些目标相关的工作假设是：h1)头部的线速度和角速度变化的幅度将与颈部肌肉的大小和僵硬负相关，并且与这些超声测量的相关性将比同时在每个平面上测量的颈部力量更强(目标1)；h2)位于头部重心下方的商用撞击传感系统产生的撞击向量将与头部的双向旋转模式相关联，而位于头部重心上方的撞击向量位置将与单向旋转相关联(目标2)。应聘者具有物理医学和康复专业的临床背景，拥有轻度创伤性脑损伤的专业知识，特别是与运动相关的脑震荡。他在临床研究、设计和统计分析方面接受过硕士水平的培训，并在生物力学工程原理和实验室技术方面接受过额外的基本培训和经验。他致力于运动脑震荡研究，专注于损伤生物力学，他计划利用通过NIH职业发展奖获得的额外培训来支持他未来在这一领域的工作。应聘者和他的指导团队设计了一项职业发展计划，以实现三个培训目标：1)精通生物力学建模技术，以便有效使用和解释人头和颈部的基本生物力学模型；2)获得肌肉骨骼超声方面的专业知识，能够熟练测量颈部肌肉大小(横截面面积)和僵硬度(弹性成像)；3)提高手艺技能，以促进持续的研究支持。

DESCRIPTION (provided by applicant): Sport-related concussion occurs when linear and angular head motion caused by external physical forces disrupts an athlete's brain function at the neuronal level. Athletes with smaller, weaker necks, including child and female athletes, are thought to be at increased risk of concussion because their necks are less able to counter these externally acting forces resulting in more violent head movement patterns. The bi-directional whiplash motion that occurs when an athlete's head rapidly changes its direction of rotation may also increase the risk of concussion associated with an individual impact, as compared to a uni-directional rotation pattern of similar magnitude. The proposed biomechanical investigation will pursue the following specific aims: AIM 1) to determine the relationship between sonographic measures of cervical muscle size and stiffness and the head's kinematic response under a standardized impulsive force in each anatomical plane across the spectra of age and gender; AIM 2) to determine whether in vivo commercial impact sensing systems can predict bi-directional versus uni-directional rotation patterns, as determined by a high speed kinematic motion capture system, during a sport-simulated bracing task. The working hypotheses associated with these aims are: H1) the magnitudes of the head's linear and angular velocity changes will be negatively associated with cervical muscle size and stiffness and will be more strongly correlated with these sonographic measures than concurrently measured neck strength in each plane (AIM 1); H2) resultant impact vectors generated by commercial impact sensing systems that are located inferior of the head's center of mass will be associated with bi-directional head rotation patterns, while impact vector locations superior to the head's center of mass will be associated with uni-directional rotation (AIM 2). The Candidate has a clinical background in Physical Medicine and Rehabilitation with expertise in mild traumatic brain injury, specifically sport-related concussion. He has master's level training in clinical research design and statistical analysis as well as additional basic training and experience in biomechanical engineering principles and laboratory techniques. He is committed to a career in sport concussion research focusing on injury biomechanics and he plans to use the additional training he receives through this NIH Career Development Award to support his future work in this field. The Candidate and his mentoring team have designed a career development plan to accomplish three training goals: 1) become proficient in biomechanical modeling techniques to permit effective use and interpretation of basic biomechanical models of the human head and neck, 2) obtain expertise in musculoskeletal ultrasonography, allowing for proficient measurement of cervical muscle size (cross sectional area) and stiffness (elastography), 3) improve grantsmanship skills to facilitate ongoing research support.