Utilizing head motion measurements integrated with clinical outcomes to inform post-concussion return to play protocols in gymnastics

利用头部运动测量与临床结果相结合，为体操中脑震荡后恢复比赛方案提供信息

• 批准号: 10570943
• 负责人: Jillian Elizabeth Urban
• 金额: $ 18.98万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-14 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10570943
• 关键词: Acceleration; Acute; Address; Affect; Age; American; Area; Assessment tool; Back; Biomechanics; Body Regions; Brain Concussion; Categories; Clinical; Clinical Assessment Tool; Clinical assessments; Cognition; Communities; Community Medicine; Complex; Craniocerebral Trauma; Data; Development; Discipline; Elements; Emergency department visit; Enrollment; Environment; Equilibrium; Evaluation; Event; Exposure to; Female; Frequencies; Goals; Gymnastics; Head; Head Movements; Height; Impairment; Injury; Investigation; Knowledge; Manufactured Baseball; Measurement; Measures; Memory; Modeling; Modification; Monitor; Motion; Musculoskeletal Equilibrium; Neurocognitive; Outcome; Participant; Play; Positioning Attribute; Protocols documentation; Random Allocation; Recommendation; Recovery; Recreation; Research; Research Project Grants; Safety; Series; Severities; Sports; Sports Medicine; Surface; Symptoms; Traumatic Brain Injury; United States; Weight; Youth; behavior measurement; college; design; experience; falls; head impact; high risk; high school; hospital care; improved; instrument; kinematics; male; motion sensor; motor impairment; motor symptom; novel; oculomotor; research study; sex; 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. As a sport, gymnastics is composed of six disciplines that utilize various skills to showcase balance, power, and artistry. The physical demands of the sport often lead to a variety of injuries, including concussion. Concussions in gymnastics commonly occur from falls and missed landings, but gymnasts are also exposed to direct (contact) and inertial (non-contact) accelerations of the head while performing complex skills that are generally not associated with concussion but may affect recovery following concussion. Additionally, athletes may experience impairments to memory, concentration, and vestibular/ocular-motor symptoms following concussion, but effects from repetitive rotational head movements, such as those experienced by gymnasts, are not well-understood. With ~ 5 million Americans participating in gymnastics-related activities, there is a critical need to understand the head accelerations experienced by gymnasts and their relationship to concussion-related clinical outcomes to inform safety recommendations, including post-concussion return to play protocols, in the sport. The objective of this study is to characterize kinematics (i.e., accelerations, velocity) of the head across skills performed in artistic gymnastics and their relationship to concussion-related clinical outcomes and evaluate the effect of safety modifications on reducing kinematic loads experienced by gymnasts. In Aim 1, 16 beginner-level (8 male, 8 female) and 16 advanced-level (8 male, 8 female) artistic gymnasts (ages 11-15) will be fitted with mouthpiece- based head motion sensors. Biomechanical data will be collected and quantified during all practices to determine the frequency, magnitude, and duration of head accelerations experienced during normal participation of the sport. In Aim 2, we will engage stakeholders in the gymnastics and sports medicine communities to identify and evaluate skill-specific safety modifications to reduce head kinematics in gymnastics. Enrolled gymnasts will complete a series of skills with two progressive safety modifications; the effect of safety modifications on reducing head accelerations will be evaluated. In Aim 3, the relationship between exposure to head accelerations during normal participation of gymnastics and concussion-related clinical outcomes will be evaluated. Changes in pre- to post-study cognition and postural control and acute changes in concussion-related symptoms will be monitored using validated clinical assessment tools and evaluated with respect to head acceleration measuring during the study. This R21 exploratory/developmental research study seeks to ultimately change the paradigm of concussion safety in gymnastics and will result in key data to support a large-scale study to develop and evaluate a biomechanically-informed return to play protocol for gymnastics. 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.

项目概要/摘要 体操是体育和娱乐相关活动中头部受伤的主要原因，也是第二大原因 非接触性运动中非致命性脑外伤导致急诊就诊的最常见原因。作为 体操是一项运动，由六个项目组成，利用各种技能来展示平衡、力量和力量。 艺术性。这项运动对身体的要求往往会导致各种伤害，包括脑震荡。脑震荡 在体操比赛中，摔伤和落地失误通常是发生的原因，但体操运动员也会遭受直接（接触） 和头部的惯性（非接触）加速度，同时执行通常不会的复杂技能 与脑震荡有关，但可能会影响脑震荡后的恢复。此外，运动员可能会经历 脑震荡后记忆力、注意力和前庭/眼运动症状受损，但影响 诸如体操运动员所经历的重复性头部旋转运动引起的疾病目前尚不清楚。 有约 500 万美国人参加体操相关活动，因此迫切需要了解体操相关活动 体操运动员经历的头部加速及其与脑震荡相关临床结果的关系 告知运动中的安全建议，包括脑震荡后重返比赛的协议。目标 这项研究的目的是表征头部跨技能的运动学（即加速度、速度） 艺术体操及其与脑震荡相关临床结果的关系并评估安全效果 减少体操运动员运动负荷的修改。在目标 1 中，16 名初级选手（8 名男性，8 名 女）和16名高级（8男，8女）艺术体操运动员（11-15岁）将配备喉舌- 基于头部运动传感器。在所有练习过程中将收集和量化生物力学数据，以确定 正常参与过程中头部加速的频率、幅度和持续时间 运动。在目标 2 中，我们将让体操和运动医学界的利益相关者参与进来，以确定和 评估特定技能的安全修改，以减少体操中的头部运动。报名的体操运动员将 通过两次渐进式安全修改完成一系列技能；安全修改对减少的影响 将评估头部加速度。在目标 3 中，暴露于头部加速度之间的关系 将评估体操的正常参与和脑震荡相关的临床结果。前的变化 研究后的认知和姿势控制以及脑震荡相关症状的急性变化将 使用经过验证的临床评估工具进行监测，并根据头部加速度测量进行评估 在学习期间。这项 R21 探索性/发展性研究旨在最终改变范式 体操中的脑震荡安全性，并将产生关键数据来支持大规模研究，以开发和 评估基于生物力学的体操重返比赛方案。这种方法将提供一个 框架可扩展到体操和杂技运动的其他学科，以提高安全性 超过500万运动员参加杂技活动。