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Self-reported Concussion History and Sensorimotor Tests Predict Head/Neck Injuries

HIDES, JULIE A.1,2; FRANETTOVICH SMITH, MELINDA M.1; MENDIS, M. DILANI1,3; TRELEAVEN, JULIA4; ROTSTEIN, ANDREW H.5; SEXTON, CHRISTOPHER T.1; LOW CHOY, NANCY6; MCCRORY, PAUL7

Medicine & Science in Sports & Exercise: December 2017 - Volume 49 - Issue 12 - p 2385–2393
doi: 10.1249/MSS.0000000000001372
Clinical Sciences

Purpose Sport-related concussion (SRC) is a risk for players involved in high-impact, collision sports. A history of SRC is a risk factor for future concussions, but the mechanisms underlying this are unknown. Despite evidence that most visible signs and symptoms associated with sports concussion resolve within 7–10 d, it has been proposed that subclinical loss of neuromuscular control and impaired motor functioning may persist and be associated with further injury. Alternatively, indicators of poor sensorimotor performance could be independent risk factors. This study investigated if a history of SRC and/or preseason sensorimotor performance predicted season head/neck injuries.

Methods A total of 190 male rugby league, rugby union, and Australian Football League players participated. Preseason assessments included self-report of SRC within the previous 12 months and a suite of measures of sensorimotor function (balance, vestibular function, cervical proprioception, and trunk muscle function). Head/neck injury data were collected in the playing season.

Results Forty-seven players (25%) reported a history of SRC. A history of concussion was related to changes in size and contraction of trunk muscles. Twenty-two (11.6%) players sustained a head/neck injury during the playing season, of which, 14 (63.6%) players had a history of SRC. Predictors of in-season head/neck injuries included history of SRC, trunk muscle function, and cervical proprioceptive errors. Five risk factors were identified, and players with three or more of these had 14 times greater risk of sustaining a season neck/head injury (sensitivity of 75% and specificity of 82.5%) than did players with two or fewer risk factors.

Conclusions The modifiable risk factors identified could be used to screen football players in the preseason and guide the development of exercise programs aimed at injury reduction.

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1Centre for Musculoskeletal Research, Mary MacKillop Institute for Health Research, Australian Catholic University, Woolloongabba, QLD, AUSTRALIA; 2Mater Back Stability Research Clinic, Mater Health Services, South Brisbane, QLD, AUSTRALIA; 3Physiotherapy Department, Mater Health Services, South Brisbane, QLD, AUSTRALIA; 4School of Health and Rehabilitation Sciences, Division of Physiotherapy, The University of Queensland, Brisbane, QLD, AUSTRALIA; 5Victoria House Medical Imaging, Prahran, VIC, AUSTRALIA; 6School of Physiotherapy, Australian Catholic University, Banyo, QLD, AUSTRALIA; and 7Florey Institute of Neuroscience & Mental Health, University of Melbourne, Parkville, VIC, AUSTRALIA

Address for correspondence: Julie Hides, Ph.D., B.Phty., M.Phty.St., School of Allied Health Sciences, Nathan Campus, Griffith University, 170 Kessels Road, Nathan, QLD 4111, Australia; E-mail: j.hides@griffith.edu.au.

Submitted for publication April 2017.

Accepted for publication July 2017.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.acsm-msse.org).

© 2017 American College of Sports Medicine