Kinematic differences during a jump cut maneuver between individuals with and without a concussion history

Lapointe, Andrew P.; Nolasco, Luis A.; Sosnowski, Aniela; Andrews, Eva; Martini, Douglas N.; Palmieri-Smith, Riann M.; Gates, Deanna H.; Broglio, Steven P.

doi:10.1016/j.ijpsycho.2017.08.003

Cited by 25 publications

(13 citation statements)

References 49 publications

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“…For example, recent preliminary evidence suggests that individuals with a history of previous concussion may be at risk for subsequent lower extremity injury after returning to sport. 5,16,21,24 Although no research has yet demonstrated this, it is plausible that physical therapy may serve as a preventive strategy to reduce risk of future non-concussion injury during sport participation.…”

Section: Discussionmentioning

confidence: 99%

Rehabilitation of an Adolescent Equestrian Athlete With a History of Multiple Concussions: A Case Report Describing an Adapted Return-to-Sport Protocol

Gunter¹,

Shields²,

Ott³

et al. 2018

J Orthop Sports Phys Ther

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Study Design Case report. Background Equestrian riding is a sport with a high risk of concussion. Currently, the literature guiding rehabilitation for concussions in equestrian athletes is limited, especially for directing return to sport. Case Description A 14-year-old female equestrian athlete presented to physical therapy following her third concussion in three years. Her primary complaints were headaches, dizziness, difficulty concentrating, light sensitivity, and neck pain. On examination, the patient demonstrated reproduction of symptoms during testing of vestibular-ocular reflex (VOR), showed a 3-line symptomatic loss on the Dynamic Visual Acuity Test (DVAT), and had impairments in the Joint Position Error (JPE) test (1/5 correct on the left; 4/5 correct on the right) and Balance Error Scoring System (BESS) (38/60 errors). A return to riding protocol was adapted from general return to sport guidelines and tailored to meet the unique demands of the patient's equestrian sport. The protocol included phased progression through no activity, light aerobic activity, moderate aerobic activity, sport-specific non-jumping skills, sport-specific jumping skills, full practice, and return to competition. During the protocol, the patient participated in eight physical therapy sessions over four weeks for vestibular training, aerobic conditioning, and cervical and core exercises, as well as equestrian exercises at her stables. Outcomes At the final evaluation, the patient reported no symptoms at rest, with exercise, or when testing VOR. Improvements were noted in the DVAT, JPE, and BESS, with changes in the BESS exceeding minimal detectable change. The patient completed the full return to riding protocol in eight weeks and was able to return to equestrian competition without complaints. Discussion This case report describes the physical therapy management and an adapted return to sport protocol for an equestrian athlete with a history of multiple sport-related concussions. Level of Evidence Therapy, level 5. J Orthop Sports Phys Ther, Epub 27 Jul 2018. doi:10.2519/jospt.2018.8214.

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Section: Discussionmentioning

confidence: 99%

Rehabilitation of an Adolescent Equestrian Athlete With a History of Multiple Concussions: A Case Report Describing an Adapted Return-to-Sport Protocol

Gunter¹,

Shields²,

Ott³

et al. 2018

J Orthop Sports Phys Ther

View full text Add to dashboard Cite

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“…Biomechanically assessing functional movement may allow for prediction and prevention of musculoskeletal injury [1][2][3] and is useful to assess return to sport readiness. 4,5 Previous work has thoroughly examined kinematic and kinetic outcomes during landing, [6][7][8][9] hopping, 5,10 and cutting 11,12 assessments without any cognitive loading. Functional movement studies are often conducted in quiet, controlled laboratory spaces in order to minimize distractions and optimize the participant's motor performance.…”

mentioning

confidence: 99%

Single- Versus Dual-Task Functional Movement Paradigms: A Biomechanical Analysis

Lempke¹,

Oh²,

Johnson³

et al. 2021

Journal of Sport Rehabilitation

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Context: Laboratory-based movement assessments are commonly performed without cognitive stimuli (ie, single-task) despite the simultaneous cognitive processing and movement (ie, dual task) demands required during sport. Cognitive loading may critically alter human movement and be an important consideration for truly assessing functional movement and understanding injury risk in the laboratory, but limited investigations exist. Objective: To comprehensively examine and compare kinematics and kinetics between single- and dual-task functional movement among healthy participants while controlling for sex. Design: Cross-sectional study. Setting: Laboratory. Patients (or Other Participants): Forty-one healthy, physically active participants (49% female; 22.5 ± 2.1 y; 172.5 ± 11.9 cm; 71.0 ± 13.7 kg) enrolled in and completed the study. Intervention(s): All participants completed the functional movement protocol under single- and dual-task (subtracting by 6s or 7s) conditions in a randomized order. Participants jumped forward from a 30-cm tall box and performed (1) maximum vertical jump landings and (2) dominant and (3) nondominant leg, single-leg 45° cuts after landing. Main Outcome Measures: The authors used mixed-model analysis of variances (α = .05) to compare peak hip, knee, and ankle joint angles (degrees) and moments (N·m/BW) in the sagittal and frontal planes, and peak vertical ground reaction force (N/BW) and vertical impulse (Ns/BW) between cognitive conditions and sex. Results: Dual-task resulted in greater peak vertical ground reaction force compared with single-task during jump landing (mean difference = 0.06 N/BW; 95% confidence interval [CI], 0.01 to 0.12; P = .025) but less force during dominant leg cutting (mean difference = −0.08 N/BW; 95% CI, −0.14 to −0.02; P = .015). Less hip-flexion torque occurred during dual task than single task (mean difference = −0.09 N/BW; 95% CI, −0.17 to −0.02). No other outcomes were different between single and dual task (P ≥ .053). Conclusions: Slight, but potentially important, kinematic and kinetic differences were observed between single- and dual-task that may have implications for functional movement assessments and injury risk research. More research examining how various cognitive and movement tasks interact to alter functional movement among pathological populations is warranted before clinical implementation.

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“…Beyond gait assessments, subtle motor-control deficits after concussion have been described during dynamicmovement tasks, such as jumping and cutting. [14][15][16] Increased lower extremity joint stiffness, 15 potentially unsafe joint loading, 16 and reaction-time differences have been reported in concussed as compared with nonconcussed (control) individuals. 14 These deficits may contribute to an increased musculoskeletal injury risk 6 and may influence long-term joint health.…”

mentioning

confidence: 99%

Single-Legged Hop and Single-Legged Squat Balance Performance in Recreational Athletes With a History of Concussion

Lynall

Campbell

Mauntel

et al. 2020

Journal of Athletic Training

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Context Researchers have suggested that balance deficiencies may linger during functional activities after concussion recovery. Objective To determine whether participants with a history of concussion demonstrated dynamic balance deficits as compared with control participants during single-legged hops and single-legged squats. Design Cross-sectional study. Setting Laboratory. Patients or Other Participants A total of 15 previously concussed participants (6 men, 9 women; age = 19.7 ± 0.9 years, height = 169.2 ± 9.4 cm, mass = 66.0 ± 12.8 kg, median time since concussion = 126 days [range = 28–432 days]) were matched with 15 control participants (6 men, 9 women; age = 19.7 ± 1.6 years, height = 172.3 ± 10.8 cm, mass = 71.0 ± 10.4 kg). Intervention(s) During single-legged hops, participants jumped off a 30-cm box placed at 50% of their height behind a force plate, landed on a single limb, and attempted to achieve a stable position as quickly as possible. Participants performed single-legged squats while standing on a force plate. Main Outcome Measure(s) Time to stabilization (TTS; time for the normalized ground reaction force to stabilize after landing) was calculated during the single-legged hop, and center-of-pressure path and speed were calculated during single-legged squats. Groups were compared using analysis of covariance, controlling for average days since concussion. Results The concussion group demonstrated a longer TTS than the control group during the single-legged hop on the nondominant leg (mean difference = 0.35 seconds [95% confidence interval = 0.04, 0.64]; F2,27 = 5.69, P = .02). No TTS differences were observed for the dominant leg ( F2,27 = 0.64, P = .43). No group differences were present for the single-legged squat on either leg ( P ≥ .11). Conclusions Dynamic balance-control deficits after concussion may contribute to an increased musculoskeletal injury risk. Given our findings, we suggest that neuromuscular deficits currently not assessed after concussion may linger. Time to stabilization is a clinically applicable measure that has been used to distinguish patients with various pathologic conditions, such as chronic ankle instability and anterior cruciate ligament reconstruction, from healthy control participants. Whereas the single-legged squat may not sufficiently challenge balance control, future study of the more dynamic single-legged hop is needed to determine its potential diagnostic and prognostic value after concussion.

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Kinematic differences during a jump cut maneuver between individuals with and without a concussion history

Cited by 25 publications

References 49 publications

Rehabilitation of an Adolescent Equestrian Athlete With a History of Multiple Concussions: A Case Report Describing an Adapted Return-to-Sport Protocol

Rehabilitation of an Adolescent Equestrian Athlete With a History of Multiple Concussions: A Case Report Describing an Adapted Return-to-Sport Protocol

Single- Versus Dual-Task Functional Movement Paradigms: A Biomechanical Analysis

Single-Legged Hop and Single-Legged Squat Balance Performance in Recreational Athletes With a History of Concussion

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