Passive cervical spine ligaments provide stability during head impacts

Kuo, Calvin; Sheffels, Jodie; Fanton, Michael; Yu, Ina Bianca; Hamalainen, Rosa; Camarillo, David B.

doi:10.1098/rsif.2019.0086

Cited by 20 publications

(14 citation statements)

References 48 publications

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“… 16 , 38 , 42 However, the significance of this effect has only generally been shown in low-severity impacts and the scalability of these results to concussive-level impacts is still unclear. 26 In addition to physical preparations before a perturbation, awareness of the perturbation may produce anticipation and affect a subject’s kinematics response. 45 Outside of conscious effort, cervical muscle activation can be manipulated by taking advantage of the acoustic startle response (ASR).…”

Section: Introductionmentioning

confidence: 99%

“…Whether during an automobile collision or an impact while playing sports, awareness of impending contact changes the risk of injury and the head’s kinematic response. 1 , 12 , 26 – 28 , 30 , 45 In football, the lack of awareness and poor posture are reported as contributing factors in concussion. 29 There are efforts to instrument helmets with antennas to predict and warn players before a severe collision to help them correct their posture or clench cervical muscles before the injurious perturbation.…”

Section: Introductionmentioning

confidence: 99%

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Cervical Muscle Activation Due to an Applied Force in Response to Different Types of Acoustic Warnings

2021

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Mild traumatic brain injury (mTBI) and whiplash-associated disorder are the most common head and neck injuries and result from a sudden head or body acceleration. The head and neck injury potential is correlated with the awareness, level of muscle activation, and posture changes at the time of the perturbation. Environmental acoustic stimuli or a warning system can influence muscle activation and posture during a head perturbation. In this study, different acoustic stimuli, including Non-Directional, Directional, and Startle, were provided 1000 ms before a head impact, and the amplitude and timing of cervical muscle electromyographic (EMG) data were characterized based on the type of warning. The startle warning resulted in 49% faster and 80% greater EMG amplitude compared to the Directional and Non-Directional warnings after warning and before the impact. The post-impact peak EMG amplitudes in Unwarned trials were lower by 18 and 21% in the retraction and rebound muscle groups, respectively, compared to any of the warned conditions. When there was no warning before the impact, the retraction and rebound muscle groups also reached their maximum activation 38 and 54 ms sooner, respectively, compared to the warned trials. Based on these results, the intensity and complexity of information that a warning sound carries change the muscle response before and after a head impact and has implications for injury potential.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cervical Muscle Activation Due to an Applied Force in Response to Different Types of Acoustic Warnings

2021

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“…neck and relative torso angles, loading condition) on neck loading with more extensive multibody models. For this reason, it was assumed that a point load would be a reasonable representation for the short durations simulated (50 ms) as has been done in previous musculoskeletal studies 40,57 .…”

Section: Discussionmentioning

confidence: 99%

“…The wrapping surfaces were defined using the MRI scans of the participant tested and were added to the musculoskeletal model. The wrapping surfaces included : i) a cylinder anterior to the lower cervical spine registered to the C6 vertebra 40 ; ii) a sphere originating and registered to the C2 vertebra; iii) two bilateral cylinders at the posterior of the upper cervical spine also registered to the C2 vertebra; iv) lastly two bilateral tori at the lower cervical spine registered to the C7 vertebra. All wrapping surfaces were constrained to move with their registered bodies as explained in Silvestros et al 33 .…”

Section: Musculoskeletal Modelmentioning

confidence: 99%

Hyperflexion is unlikely to be the primary cervical spine injury mechanism in accidental head-on rugby tackling

Silvestros

Preatoni

Gill

et al. 2022

Preprint

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In Rugby a high proportion of catastrophic cervical spine injuries occur during tackling. In the injury prevention literature, there is still an open debate on the injury mechanisms related to such injuries, with hyperflexion and buckling being under scrutiny. The aims of this study were to determine the primary cervical spine injury mechanism during head-on rugby tackling, and evaluate the effect of tackling technique on cervical spine intervertebral loading. We conducted an in silico study to examine the dynamic response of the cervical spine under loading conditions representative of accidental head-on rugby tackles by using a subject-specific musculoskeletal model of a rugby player. The computer simulations were driven by experimental in vivo data of an academy rugby player tackling a punchbag, and in vitro data of head-first impacts using a dummy head. Results showed that: i) the earlier generation of high compression and anterior shear loads with low values of flexion moments provides evidence that hyperflexion is unlikely to be the primary injury mechanism in the sub-axial cervical spine (C3-C7) during central and posterior head impact locations; ii) a higher degree of neck flexion at impact poses the cervical spine in a more hazardous position. These findings provide objective evidence to inform injury prevention strategies or rugby law changes, with the final view of improving the safety of the game of rugby.

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“…Pre-activation with the OpenSim computed muscle control method and PID-based control strategies were included in the Human Active Lower Limb (HALL) model for lower limbs [14,15]. Some MB models with muscle control strategies were also developed for investigating active muscle effects during sportive or impact injuries, etc., from 1-pivot models [16][17][18][19] to detailed subsegments [20][21][22][23][24][25]. Recently, Happee et al [26] developed a multisegment head-neck model incorporating several neural controllers in Matlab programming environment.…”

Section: Introductionmentioning

confidence: 99%

A Novel Neuromuscular Head-Neck Model and Its Application on Impact Analysis

Zheng

2021

IEEE Trans. Neural Syst. Rehabil. Eng.

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Objective: Neck muscle activation plays an important role in maintaining posture and preventing trauma injuries of the head-neck system, levels of which are primarily controlled by the neural system. Thus, the present study aims to establish and validate a neuromuscular headneck model as well as to investigate the effects of realistic neural reflex control on head-neck behaviors during impact loading. Methods: The neuromuscular head-neck model was first established based on a musculoskeletal model by including neural reflex control of the vestibular system and proprioceptors. Then, a series of human posture control experiments was implemented and used to validate the model concerning both joint kinematics of the cervical spine and neck muscle activations. Finally, frontal impact experiments of varying loading severities were simulated with the newly established model and compared with an original model to investigate the influences of the implanted neural reflex controllers on head-neck kinematic responses. Results: The simulation results using the present neuromuscular model showed good correlations with in-vivo experimental data while the original model even cannot reach a correct balance status. Furthermore, the vestibular reflex is noted to dominate the muscle activation in less severe impact loadings while both vestibular and proprioceptive controllers have a lot of effect in higher impact loading severity cases. Conclusions: In summary, a novel neuromuscular head-model was established and its application demonstrated the significance of the neural reflex control in predicting in vivo head-neck responses and preventing related injury risk due to impact loading.

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Passive cervical spine ligaments provide stability during head impacts

Cited by 20 publications

References 48 publications

Cervical Muscle Activation Due to an Applied Force in Response to Different Types of Acoustic Warnings

Cervical Muscle Activation Due to an Applied Force in Response to Different Types of Acoustic Warnings

Hyperflexion is unlikely to be the primary cervical spine injury mechanism in accidental head-on rugby tackling

A Novel Neuromuscular Head-Neck Model and Its Application on Impact Analysis

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