Perceptual-Motor Efficiency and Concussion History Are Prospectively Associated With Injury Occurrences Among High School and Collegiate American Football Players

Abstract

Background: After a sport-related concussion (SRC), the risk for lower extremity injury is approximately 2 times greater, and the risk for another SRC may be as much as 3 to 5 times greater. Purpose: To assess the predictive validity of screening methods for identification of individual athletes who possess an elevated risk of SRC. Study Design: Case-control study; Level of evidence, 3. Methods: Metrics derived from a smartphone flanker test software application and self-ratings of both musculoskeletal function and overall wellness were acquired from American high school and college football players before study participation. Occurrences of core or lower extremity injury (CLEI) and SRC were documented for all practice sessions and games for 1 season. Receiver operating characteristic and logistic regression analyses were used to identify variables that provided the greatest predictive accuracy for CLEI or SRC occurrence. Results: Overall, there were 87 high school and 74 American college football players included in this study. At least 1 CLEI was sustained by 45% (39/87) of high school players and 55% (41/74) of college players. Predictors of CLEI included the flanker test conflict effect ≥69 milliseconds (odds ratio [OR], 2.12; 90% CI, 1.24-3.62) and a self-reported lifetime history of SRC (OR, 1.70; 90% CI, 0.90-3.23). Of players with neither risk factor, only 38% (29/77) sustained CLEI compared with 61% (51/84) of players with 1 or both of the risk factors (OR, 2.56; 90% CI, 1.50-4.36). SRC was sustained by 7 high school players and 3 college players. Predictors of SRC included the Overall Wellness Index score ≤78 (OR, 9.83; 90% CI, 3.17-30.50), number of postconcussion symptoms ≥4 (OR, 8.35; 90% CI, 2.71-25.72), the Sport Fitness Index score ≤78 (OR, 5.16; 90% CI, 1.70-15.65), history of SRC (OR, 4.03; 90% CI, 1.35-12.03), and the flanker test inverse efficiency ratio ≥1.7 (OR, 3.19; 90% CI, 1.08-9.47). Conclusion: Survey responses and smartphone flanker test metrics predicted greater injury incidence among individual football players classified as high-risk compared with that for players with a low-risk profile.

Preseason Prognostic Factors for Injuries and Match Loss in Collision Sports: A Systematic Review

“…The list of the literature excluded in the full-text inspection is summarized in Supplementary Table 1. The risk of bias was assessed in 57 studies 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 , whose details have been summarized in Supplementary Table 2. One study was written in Japanese 72 , and others were written in English.…”

Sex Moderates the Relationship between Perceptual-Motor Function and Single-Leg Squatting Mechanics

“…As an exploratory investigation, we recruited a convenience sample and did not perform an a priori power analysis, resulting in unbalanced sex cohorts. Future work should aim to have groups with similar distributions of males and females and larger sample sizes for greater inclusion of additional, potentially relevant variables in the statistical models (e.g., controlling for history of sports-related concussion (Wilkerson et al, 2021a)). Also, we elected to use a single-leg squat, and although we did observe meaningful sex-specific relationships, we acknowledge that a more dynamic task could have yielded alternative results.…”

Changes in dual-task cognitive performance elicited by physical exertion vary with motor task

“…Following baseline dual-task assessment, participants completed a treadmill protocol that was designed to impose a moderate-to-vigorous intensity aerobic demand, such as would be experienced in a practice or game and was not intended to induce a fatigued condition. The 20-min treadmill protocol consisted of a 5 min warmup, followed by a self-selected pace such that each participant attained a rating of perceived exertion (RPE) ( 31 ) of 15–18 for the final 12 min of the 20-min bout, as determined by self-report at each minute of the protocol ( 32 ). Following the exertional treadmill protocol, participants rested for ~10 min prior to completion of post-exercise dual-task assessments.…”