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Glendon K, Pain MTG, Hogervorst E, Belli A, Blenkinsop G. Musculoskeletal injury or Sports-Related Concussion (SRC) in a season of rugby union does not affect performance on concussion battery testing in university-aged student-athletes. Phys Ther Sport 2024; 65:137-144. [PMID: 38181564 DOI: 10.1016/j.ptsp.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/08/2023] [Accepted: 12/18/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND Sub-concussive and concussive impacts sustained during contact sports such as rugby may affect neurocognitive performance, vestibular-ocular-motor function, symptom burden and academic ability. METHOD Student-athletes (n = 146) participating in rugby union British Universities or domestic competitions were assessed on the Immediate Post-Concussion and Cognitive Test, Post-Concussion Symptom Scale, vestibular-oculo-motor screening tool and revised perceived academic impact tool. Individual change from pre-season (July-September 2021) to 2-weeks following last exposure to contact (April-July 2022) was analysed. RESULTS Symptom burden significantly worsened (p=0.016) over the season. Significant improvements on verbal memory (p=0.016), visual memory (p=0.008) and motor processing speed (p=0.001) suggest a possible learning effect. Surprisingly, the number of days lost to concussion significantly and positively affected performance on verbal memory (p = 0.018) and reaction time (p = 0.027). Previous concussive events significantly predicted a worsening in symptom burden (p < 0.028), as did in-season concussive events, predicting improved verbal memory (p = 0.033) and symptom burden change (p = 0.047). Baseline performance significantly affected change on several neurocognitive tests, with low-scorers showing more improvement over the season. CONCLUSION Participation in rugby union was not associated with deleterious effects on brain function. Previous concussive events and in-season factors, possibly related to learning effects, may explain improvement in cognitive function across the season.
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Affiliation(s)
- K Glendon
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
| | - M T G Pain
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - E Hogervorst
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - A Belli
- Institute of Inflammation and Ageing, University of Birmingham, UK
| | - G Blenkinsop
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
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Grijalva C, Mullins VA, Michael BR, Hale D, Wu L, Toosizadeh N, Chilton FH, Laksari K. Neuroimaging, wearable sensors, and blood-based biomarkers reveal hyperacute changes in the brain after sub-concussive impacts. Brain Multiphys 2023; 5:100086. [PMID: 38292249 PMCID: PMC10827333 DOI: 10.1016/j.brain.2023.100086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Abstract
Impacts in mixed martial arts (MMA) have been studied mainly in regard to the long-term effects of concussions. However, repetitive sub-concussive head impacts at the hyperacute phase (minutes after impact), are not understood. The head experiences rapid acceleration similar to a concussion, but without clinical symptoms. We utilize portable neuroimaging technology - transcranial Doppler (TCD) ultrasound and functional near infrared spectroscopy (fNIRS) - to estimate the extent of pre- and post-differences following contact and non-contact sparring sessions in nine MMA athletes. In addition, the extent of changes in neurofilament light (NfL) protein biomarker concentrations, and neurocognitive/balance parameters were determined following impacts. Athletes were instrumented with sensor-based mouth guards to record head kinematics. TCD and fNIRS results demonstrated significantly increased blood flow velocity (p = 0.01) as well as prefrontal (p = 0.01) and motor cortex (p = 0.04) oxygenation, only following the contact sparring sessions. This increase after contact was correlated with the cumulative angular acceleration experienced during impacts (p = 0.01). In addition, the NfL biomarker demonstrated positive correlations with angular acceleration (p = 0.03), and maximum principal and fiber strain (p = 0.01). On average athletes experienced 23.9 ± 2.9 g peak linear acceleration, 10.29 ± 1.1 rad/s peak angular velocity, and 1,502.3 ± 532.3 rad/s2 angular acceleration. Balance parameters were significantly increased following contact sparring for medial-lateral (ML) center of mass (COM) sway, and ML ankle angle (p = 0.01), illustrating worsened balance. These combined results reveal significant changes in brain hemodynamics and neurophysiological parameters that occur immediately after sub-concussive impacts and suggest that the physical impact to the head plays an important role in these changes.
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Affiliation(s)
- Carissa Grijalva
- University of Arizona, Department of Biomedical Engineering, Tucson, AZ, United States
| | - Veronica A. Mullins
- University of Arizona, School of Nutritional Sciences and Wellness, Tucson, AZ, United States
| | - Bryce R. Michael
- University of Arizona, School of Nutritional Sciences and Wellness, Tucson, AZ, United States
| | - Dallin Hale
- University of Arizona, Department of Physiology, Tucson, AZ, United States
| | - Lyndia Wu
- Univerisity of British Columbia, Department of Mechanical Engineering, Vancouver, BC, Canada
| | - Nima Toosizadeh
- University of Arizona, Department of Biomedical Engineering, Tucson, AZ, United States
- University of Arizona, Department of Medicine, Arizona Center for Aging, Tucson, AZ, United States
| | - Floyd H. Chilton
- University of Arizona, School of Nutritional Sciences and Wellness, Tucson, AZ, United States
| | - Kaveh Laksari
- University of Arizona, Department of Biomedical Engineering, Tucson, AZ, United States
- University of Arizona, Department of Aerospace and Mechanical Engineering, Tucson, AZ, United States
- University of California Riverside, Department of Mechanical Engineering, Riverside, CA, United States
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Brooks JS, Redgrift A, Champagne AA, Dickey JP. The Hammer and the Nail: Biomechanics of Striking and Struck Canadian University Football Players. Ann Biomed Eng 2021; 49:2875-2885. [PMID: 33893576 PMCID: PMC8510945 DOI: 10.1007/s10439-021-02773-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/27/2021] [Indexed: 01/04/2023]
Abstract
This study sought to evaluate head accelerations in both players involved in a football collision. Players on two opposing Canadian university teams were equipped with helmet mounted sensors during one game per season, for two consecutive seasons. A total of 276 collisions between 58 instrumented players were identified via video and cross-referenced with sensor timestamps. Player involvement (striking and struck), impact type (block or tackle), head impact location (front, back, left and right), and play type were recorded from video footage. While struck players did not experience significantly different linear or rotational accelerations between any play types, striking players had the highest linear and rotational head accelerations during kickoff plays (p ≤ .03). Striking players also experienced greater linear and rotational head accelerations than struck players during kickoff plays (p = .001). However, struck players experienced greater linear and rotational accelerations than striking players during kick return plays (p ≤ .008). Other studies have established that the more severe the head impact, the greater risk for injury to the brain. This paper's results highlight that kickoff play rule changes, as implemented in American college football, would decrease head impact exposure of Canadian university football athletes and make the game safer.
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Affiliation(s)
- Jeffrey S. Brooks
- grid.39381.300000 0004 1936 8884School of Kinesiology, Faculty of Health Sciences, Western University, 1151 Richmond St., London, ON Canada
| | - Adam Redgrift
- grid.39381.300000 0004 1936 8884School of Kinesiology, Faculty of Health Sciences, Western University, 1151 Richmond St., London, ON Canada
| | - Allen A. Champagne
- grid.410356.50000 0004 1936 8331Centre for Neuroscience Studies, Queen’s University, Kingston, ON Canada ,grid.410356.50000 0004 1936 8331School of Medicine, Queen’s University, Kingston, ON Canada
| | - James P. Dickey
- grid.39381.300000 0004 1936 8884School of Kinesiology, Faculty of Health Sciences, Western University, 1151 Richmond St., London, ON Canada
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Dierijck JK, Wright AD, Smirl JD, Bryk K, van Donkelaar P. Sub-concussive trauma, acute concussion, and history of multiple concussions: Effects on quiet stance postural control stability. Int J Psychophysiol 2018. [PMID: 29526776 DOI: 10.1016/j.ijpsycho.2018.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Although balance control has been studied extensively following acute concussion, little is known regarding repetitive sub-concussive head impacts or chronic exposure to multiple concussive events. Quiet stance postural control was characterized in contact sport athletes at pre-season (n = 135) and post-season (n = 48) to evaluate the effects of subconcussive trauma to the head. To determine the impact of acute concussion on postural control, athletes diagnosed with a concussion during the season (n = 12) were tested at 72-h, 2-weeks, and 1-month post-injury. Because only 4 of the concussed athletes completed baseline testing, control athletes (n = 12) matched for sport, age, body mass index (BMI), and previous concussion history served as a comparison group. Finally, the effects of previous concussion history on quiet stance postural control were determined by comparing pre-season data in contact sport athletes with either zero (Hx0, n = 50) or three or more (Hx3+, n = 25) previous concussions. A force plate was used to compare changes in centre-of-pressure root-mean-square displacement (RMSdisp) and mean-velocity (COPvel) in the anterior/posterior (AP) and medial/lateral (ML) directions. One-minute trials were performed with feet hip-width apart, hands-on-hips, and A) eyes-open and B) eyes-closed. Biomechanical head-impact exposure (impacts over 10 g) was indexed over the season using mastoid-fixed impact sensors. In acutely injured athletes, repeated-measures ANOVA revealed a significant effect of time for RMSdisp AP with increased displacement at 2 weeks compared to 72 h (p = 0.008, 95% CI: -0.180, -0.310 cm). No other COP variables were affected by acute concussion. Moreover, there was no effect of concussion history or repeated sub-concussive impacts on any quiet stance metric. Additionally, head-impact exposure metrics were not correlated with COP metrics. Taken together, the data suggests alterations in COP sway during quiet stance persist in the acute 2-week period after injury. These findings were not present with either a history of multiple concussions or exposure to sub-concussive head impacts indicating acute concussion does not have appear to have long term effects for these measures.
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Affiliation(s)
- J K Dierijck
- School of Health and Exercise Sciences, University of British Columbia, ART 360 - 3333 University Way, Kelowna, BC V1V 1V7, Canada
| | - A D Wright
- School of Health and Exercise Sciences, University of British Columbia, ART 360 - 3333 University Way, Kelowna, BC V1V 1V7, Canada; MD/PhD Program, University of British Columbia, 2894 Detwiller Pavilion, 2255 Wesbrook Mall, Vancouver, BC V6T 2A1, Canada; Southern Medical Program, Reichwald Health Sciences Centre, University of British Columbia Okanagan, 1088 Discovery Avenue, Kelowna, BC V1V 1V7, Canada; Experimental Medicine Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - J D Smirl
- School of Health and Exercise Sciences, University of British Columbia, ART 360 - 3333 University Way, Kelowna, BC V1V 1V7, Canada
| | - K Bryk
- School of Health and Exercise Sciences, University of British Columbia, ART 360 - 3333 University Way, Kelowna, BC V1V 1V7, Canada; Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA
| | - P van Donkelaar
- School of Health and Exercise Sciences, University of British Columbia, ART 360 - 3333 University Way, Kelowna, BC V1V 1V7, Canada.
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