Reducing subsequent injuries after a concussion

Date:
March 9, 2022
Source:
University of Colorado Anschutz Medical Campus
Summary:
Looking for techniques to keep young athletes safer post-concussion,
researchers devised a study in which teenage athletes who suffered
concussions were randomized either to standard of care -- typically
returning to play after clearing a set of standardized protocols
that assess symptoms, cognition, and balance -- or completing
the same protocol and then working with an athletic trainer on a
specific neuromuscular training intervention that includes guided
strength exercises and a focus on posture and landing stability.



FULL STORY ==========================================================================
As assistant professor of orthopedics at the University of Colorado
School of Medicine, David Howell, PhD, understands the relationship
between concussions and subsequent injury in athletes -- namely, that
after suffering a concussion, athletes at all levels are more likely to
sustain another injury within the next year.


==========================================================================
"Any athlete may experience an injury such as an ankle sprain or an ACL
rupture -- that's just a part of sports," says Howell, lead researcher
for sports medicine at Children's Hospital Colorado. "However, people with recent concussions tend to be particularly vulnerable to these. Even after symptoms have subsided and an athlete is cleared to go back to sports,
we still see neuromuscular motor control deficits, particularly when
they are paired with a cognitive task. Those lingering deficits might predispose them to further injury." Enter the intervention Looking for techniques to keep young athletes safer post-concussion, Howell and the investigative team devised a study in which teenage athletes who suffered concussions were randomized either to standard of care -- typically
returning to play after clearing a set of standardized protocols that
assess symptoms, cognition, and balance -- or completing the same protocol
and then working with an athletic trainer on a specific neuromuscular
training intervention that includes guided strength exercises and a
focus on posture and landing stability.

"It's similar to injury risk reduction programs that are used more
in population-level studies," Howell says. "You take an entire high
school soccer team and run them through these neuromuscular training
programs over a season, then compare them to a team that didn't do the
program. Those studies showed that if you have a team go through this,
it can reduce the risk of ACL tears, for example, pretty significantly."
Howell enrolled 27 post-concussion youth athletes in the study, most of
whom were patients in the Sports Medicine Center at Children's Hospital Colorado.

The athletes who were randomized to the intervention worked with an
athletic trainer two times a week for eight weeks; researchers followed
them for a full year following their concussion.

"We asked them every month over the following year, 'Did you play
sports? How many games did you have? How many practices do you have? How
many hours did you participate' -- plus, 'Did you get injured or
not?'" Howell says. "What we found is that the people who went through
the intervention had about a three- and-a-half times reduced injury risk compared to the ones that did not go through the intervention over that
next year." Changing the rules on return-to-play Howell hopes the results
from his study will eventually change the way athletes are returned to
play, shifting focus from computerized tests and self-reported symptoms to
a standardized intervention that can help stave off additional injuries.

He and his research team are even working on an app that will support
athletes through a self-guided training program in situations where they
don't have access to a trained clinician, such as an athletic trainer
or physical therapist.

"When you think about sports, it's not just looking at a computer screen,
doing a reaction time test or a single balance test," he says. "It's an integration of many different systems. You think about a soccer pass,
for example -- you're standing here, there's a teammate across the way
to try to pass it to. But what's your angle of your foot doing? Where
are the opponents? All those things require a lot of cognitive and fine
motor skills that happened in rapid succession.

"If this can help with at least some of those elements that can contribute
to safety, we think that can have an effect," he says. "The results of
this preliminary study were really encouraging, and I'm excited about
where we're going from here."

========================================================================== Story Source: Materials provided by University_of_Colorado_Anschutz_Medical_Campus. Original written by Greg Glasgow. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. David R. Howell, Corrine N. Seehusen, Patrick M. Carry, Gregory A.

Walker, Sarah E. Reinking, Julie C. Wilson. An 8-Week Neuromuscular
Training Program After Concussion Reduces 1-Year Subsequent Injury
Risk: A Randomized Clinical Trial. The American Journal of Sports
Medicine, 2022; 036354652110693 DOI: 10.1177/03635465211069372 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/03/220309131850.htm

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