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: 10456187
• 负责人: Jillian Elizabeth Urban
• 金额: $ 7.37万
• 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 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10456187
• 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; 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; pilot test; 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.

项目总结/摘要 体操是运动和娱乐相关活动中头部受伤的主要原因， 在非接触性运动中，非致命性创伤性脑损伤是急诊室就诊的最常见原因。 尽管如此，在体操中的回归比赛协议几乎没有被研究。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， 利用各种技巧展示平衡、力量和艺术性的有氧体操。妇女的艺术 体操是体操中最受欢迎的项目，被推荐用于发展力量 和协调能力。然而，这项运动的身体要求往往导致各种各样的 受伤，包括脑震荡，女性在体操中所占的比例更高- 在医院治疗的相关伤害。从脑震荡中恢复的运动员重新融入体育运动， 一个引导返回播放协议。现有的脑震荡后恢复比赛协议是为接触性运动开发的， 例如足球，可能与杂技运动无关，也没有生物力学依据 从而形成体操运动员独特的曝光率。大约有500万美国人参加了与体操有关的活动， 活动，有一个关键需要了解复杂的负荷环境的头部在体操， 告知这项运动中的重返比赛协议。本研究的目的是描述头部的运动学特征 跨越女子艺术体操技能的发展， 回到比赛中来在目标1中，11名初级（11-13岁）和11名高级（13-15岁） 体操运动员将配备基于耳机的头部运动传感器。将收集生物力学数据， 在所有练习中进行量化，以确定头部加速度的频率和幅度 在正常的体育活动中。一个子样本的运动员将完成一系列的技能与两个 渐进式安全改进，以评估安全改进对降低头部加速度的影响。在 目标2，混合方法将用于整合从文献和数据中确定的重返赛场指南， 目标1。利益相关者将参与制定和完善生物力学知情的脑震荡后返回 在女子艺术体操比赛中遵守规则结果将包括方案的特征， 供国家组织考虑采用的传播材料。R 03小型试点研究旨在 改变体操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，评估重返赛场方案在减少症状性 脑震荡后的发作和恢复时间，同时评估本研究中的最佳实施策略。 环境这种方法将提供一个框架，可能会扩大到其他学科的体操 和杂技运动，提高500多万名参加杂技活动的运动员的安全。