Biomechanical Basis of Pediatric mTBI Due to Sports Related Concussion

运动相关脑震荡引起的小儿 mTBI 的生物力学基础

• 批准号: 9029364
• 负责人: Stefan Duma
• 金额: $ 65.63万
• 依托单位: VIRGINIA POLYTECHNIC INST AND ST UNIV
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-03-15 至 2020-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9029364
• 关键词: Acceleration; Adult; Age; Athletic; Biomechanics; Biomedical Engineering; Brain; Brain Concussion; Brain Injuries; Childhood; Clinical; Clinical Data; Data; Data Collection; Databases; Detection; Development; Devices; Diagnosis; Diagnostic; Environment; Equipment; Evaluation; Exposure to; Freedom; General Population; Goals; Head; Health; Healthcare; Helmet; Incidence; Injury; Knowledge; Logistic Regressions; Manufactured football; Measurement; Measures; Methods; Modeling; Outcome; Pilot Projects; Play; Population; Practice Guidelines; Prevention; Prevention strategy; Preventive Intervention; Recording of previous events; Research; Risk; Seasons; Severities; Signs and Symptoms; Site; Sports; System; Technology; Telemetry; Testing; Therapeutic; Translational Research; United States; United States National Institutes of Health; Validation; Vehicle crash; Work; Youth; aged; base; biomechanical model; cognitive change; cohort; college; consumer product; design; experience; head impact; improved; in vivo; instrument; member; mild traumatic brain injury; novel; novel strategies; outcome forecast; pathomechanics; prevention evaluation; research and development; tool

 DESCRIPTION (provided by applicant): We propose to develop a quantitative model of the biomechanical basis of mild traumatic brain injury (MTBI) for a pediatric population. This expands upon our initial five year Bioengineering Research Partnership (BRP) in which we developed a biomechanical model of MTBI for a collegiate population, which has resulted in a database of more than 500,000 recorded head impacts in collegiate sports. This work has produced substantial advancements in the knowledge of injury mechanisms and head impact exposure, and resulted in translational outcomes, including: 1) adult brain injury criteria that provide improved diagnosis strategies and prevention systems, 2) optimized helmet design criteria and publically available helmet evaluations that have improved helmet technologies, and 3) football practice guidelines that have reduced head impact exposure in collegiate football. The proposed pediatric MTBI model will enable translational research and the development of new clinical and therapeutic approaches to reduce the incidence and negative effects of MTBI in youth athletes. Experimental and clinical projects among our team members will allow us to test hypotheses specific to the underlying pathomechanics and clinical sequelae of pediatric MTBI. A cohort of 1050 youth football players between the ages of 6 and 14 years will wear instrumented helmets to collect head acceleration data and clinical data over a 5 year period. Athletic environments offer a rich opportunity for collecting data on large numbers of head impacts, which enables research that combines biomechanical head impact data with the subsequent neurobiologic and functional changes in the brain. To date, biomechanical MTBI research has focused primarily on the approximately 100,000 athletes participating in college and professional football in the United States; however, little is known about the 3,500,000 youth (6 years to 14 years) athletes playing football each year. We hypothesize that head acceleration due to impact is predictive of the type and severity of brain injury, and correlates t specific clinical measures of pediatric MTBI. We aim to: 1) Quantify head impact exposure in youth football, 2) Determine head acceleration injury tolerance for sustaining pediatric MTBI, and 3) Correlate head acceleration with clinical variables related to pediatric MTBI. We have performed a pilot study on 119 youth football players aged 7 to 18 years to demonstrate the feasibility of the proposed work. Successful completion of the proposed hypothesis-driven research will result in the development of novel protective equipment strategies, diagnostic tools for field use and other healthcare settings, novel strategies for return to play decisions, and educational tools for disseminating information about the evaluation and prevention of MTBI in the pediatric population. Additionally, our research results will have translational relevance to the general population, including motor vehicle crashes and pediatric consumer products.

 描述（由申请人提供）：我们建议为儿科人群开发轻度创伤性脑损伤（MTBI）生物力学基础的定量模型。这扩展了我们最初的五年生物工程研究合作伙伴关系（BRP），其中我们为大学人群开发了MTBI的生物力学模型，这导致了一个超过50万记录的大学体育运动中头部撞击的数据库。这项工作在损伤机制和头部撞击暴露的知识方面取得了实质性进展，并产生了转化成果，包括：1）提供改进的诊断策略和预防系统的成人脑损伤标准，2）优化的头盔设计标准和具有改进的头盔技术的医学上可用的头盔评估，和3）橄榄球练习指南，减少了大学橄榄球中的头部撞击暴露。拟议的儿科MTBI模型将使转化研究和新的临床和治疗方法的开发，以减少MTBI在青年运动员中的发病率和负面影响。我们团队成员之间的实验和临床项目将使我们能够测试针对儿科MTBI的潜在病理机制和临床后遗症的假设。一组1050名6至14岁的青少年足球运动员将戴上仪器头盔，收集5年内的头部加速度数据和临床数据。运动环境为收集大量头部撞击的数据提供了丰富的机会，这使得研究能够将生物力学头部撞击数据与随后的大脑神经生物学和功能变化相结合。迄今为止，生物力学MTBI研究主要集中在美国参加大学和职业足球的大约10万名运动员;然而，对每年参加足球比赛的3，500，000名青少年（6岁至14岁）运动员知之甚少。我们假设，由于撞击导致的头部加速度可以预测脑损伤的类型和严重程度，并与儿科MTBI的特定临床指标相关。我们的目标是：1）量化青少年足球中的头部撞击暴露，2）确定维持儿科MTBI的头部加速度损伤耐受性，以及3）将头部加速度与儿科MTBI相关的临床变量相关联。我们对119名7至18岁的青少年足球运动员进行了试点研究，以证明拟议工作的可行性。成功完成拟议的假设驱动的研究将导致开发新的防护设备策略，现场使用和其他医疗保健环境的诊断工具，返回游戏决策的新策略，以及传播有关儿科人群MTBI评估和预防信息的教育工具。此外，我们的研究结果将与普通人群具有转化相关性，包括机动车碰撞和儿科消费品。