TY - JOUR
T1 - Do Head Injury Biomechanics Predict Concussion Clinical Recovery in College American Football Players?
AU - CARE Consortium Investigators
AU - Mihalik, Jason P.
AU - Chandran, Avinash
AU - Powell, Jacob R.
AU - Roby, Patricia R.
AU - Guskiewicz, Kevin M.
AU - Stemper, Brian D.
AU - Shah, Alok S.
AU - Rowson, Steven
AU - Duma, Stefan
AU - Harezlak, Jaroslaw
AU - Riggen, Larry
AU - Broglio, Steven P.
AU - McAllister, Thomas W.
AU - McCrea, Michael
AU - Brooks, Alison
AU - Jackson, Jonathan
AU - Cameron, Kenneth
AU - Houston, Megan
N1 - Funding Information:
This investigation was made possible, in part, with support from the Grand Alliance Concussion Assessment, Research, and Education (CARE) Consortium, funded, by the National Collegiate Athletic Association (NCAA) and the Department of Defense (DoD). The U.S. Army Medical Research Acquisition Activity, 820 Chandler Street, Fort Detrick MD 21702-5014 is the awarding and administering acquisition office. This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs through the Psychological Health and Traumatic Brain Injury Program under Award No. W81XWH-14-2-0151. Opinions, interpretations, conclusions and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (DHP funds). The authors would also like to thank Jody Harland, Janetta Matesan (Indiana University); Ashley Rettmann and Nicole L’Heureux (University of Michigan); Melissa Koschnitzke (Medical College of Wisconsin); Michael Jarrett, Vibeke Brinck and Bianca Byrne (Quesgen); Thomas Dompier, Christy Collins, Melissa Niceley Baker, and Sara Dalton (Datalys Center for Sports Injury Research and Prevention); and the research and medical staff at each of the participating sites. CARE Consortium Investigators: The authors would like to thank the individual site PIs and the study personnel they represent who ensured appropriate participant recruitment, data collection, and providing clinical care to those who were injured. Those site PIs are Alison Brooks (University of Wisconsin), Jonathan Jackson (Air Force Academy), Kenneth Cameron and Megan Houston (West Point Academy), and others from University of California at Los Angeles and Air Force Academy.
Funding Information:
This investigation was made possible, in part, with support from the Grand Alliance Concussion Assessment, Research, and Education (CARE) Consortium, funded, by the National Collegiate Athletic Association (NCAA) and the Department of Defense (DoD). The U.S. Army Medical Research Acquisition Activity, 820 Chandler Street, Fort Detrick MD 21702-5014 is the awarding and administering acquisition office. This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs through the Psychological Health and Traumatic Brain Injury Program under Award No. W81XWH-14-2-0151. Opinions, interpretations, conclusions and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (DHP funds).
Publisher Copyright:
© 2020, Biomedical Engineering Society.
PY - 2020/11
Y1 - 2020/11
N2 - Identifying the associations between head impact biomechanics and clinical recovery may inform better head impact monitoring procedures and identify athletes who may benefit from early treatments aimed to enhance recovery. The purpose of this study was to test whether head injury biomechanics are associated with clinical recovery of symptom severity, balance, and mental status, as well as symptom resolution time (SRT) and return-to-participation (RTP) time. We studied 45 college American football players (n = 51 concussions) who sustained an incident concussion while participating in a multi-site study. Player race/ethnicity, prior concussion, medical history, position, body mass index, event type, and impact location were covariates in our multivariable analyses. Multivariable negative binomial regression models analyzed associations between our study outcomes and (1) injury-causing linear and rotational head impact severity, (2) season repetitive head impact exposure (RHIE), and (3) injury day RHIE. Median SRT was 6.1 days (IQR 5.8 days, n = 45) and median RTP time was 12.3 days (IQR 7.8 days, n = 36) across our study sample. RTP time was 86% (Ratio 1.86, 95% CI [1.05, 3.28]) longer in athletes with a concussion history. Offensive players had SRTs 49% shorter than defensive players (Ratio 0.51, 95% CI [0.29, 0.92]). Per-unit increases in season RHIE were associated with 22% longer SRT (Ratio 1.22, 95% CI [1.09, 1.36]) but 28% shorter RTP time (Ratio 0.72, 95% CI [0.56, 0.93]). No other head injury biomechanics predicted injury recovery.
AB - Identifying the associations between head impact biomechanics and clinical recovery may inform better head impact monitoring procedures and identify athletes who may benefit from early treatments aimed to enhance recovery. The purpose of this study was to test whether head injury biomechanics are associated with clinical recovery of symptom severity, balance, and mental status, as well as symptom resolution time (SRT) and return-to-participation (RTP) time. We studied 45 college American football players (n = 51 concussions) who sustained an incident concussion while participating in a multi-site study. Player race/ethnicity, prior concussion, medical history, position, body mass index, event type, and impact location were covariates in our multivariable analyses. Multivariable negative binomial regression models analyzed associations between our study outcomes and (1) injury-causing linear and rotational head impact severity, (2) season repetitive head impact exposure (RHIE), and (3) injury day RHIE. Median SRT was 6.1 days (IQR 5.8 days, n = 45) and median RTP time was 12.3 days (IQR 7.8 days, n = 36) across our study sample. RTP time was 86% (Ratio 1.86, 95% CI [1.05, 3.28]) longer in athletes with a concussion history. Offensive players had SRTs 49% shorter than defensive players (Ratio 0.51, 95% CI [0.29, 0.92]). Per-unit increases in season RHIE were associated with 22% longer SRT (Ratio 1.22, 95% CI [1.09, 1.36]) but 28% shorter RTP time (Ratio 0.72, 95% CI [0.56, 0.93]). No other head injury biomechanics predicted injury recovery.
KW - Angular
KW - Head impact sensors
KW - Injury severity
KW - Mechanics
KW - NCAA-DOD CARE Consortium
UR - http://www.scopus.com/inward/record.url?scp=85094920232&partnerID=8YFLogxK
U2 - 10.1007/s10439-020-02658-y
DO - 10.1007/s10439-020-02658-y
M3 - Article
C2 - 33136240
AN - SCOPUS:85094920232
SN - 0090-6964
VL - 48
SP - 2555
EP - 2565
JO - Annals of Biomedical Engineering
JF - Annals of Biomedical Engineering
IS - 11
ER -