Post-Concussion Neuromuscular Function and Musculoskeletal Injury Risk
Walter Reed National Military Medical Center
Summary
Musculoskeletal injuries (MSKI) and traumatic brain injury (TBI) are the signature injuries of the ongoing military conflicts. MSKI affect 800,000 Service Members annually and TBI have impacted more than 350,000 in the past 19 years and account for 22% of all combat casualties. Concussion, a mild form of TBI, increases MSKI risk in physically active individuals, including Service Members. The overall goal of the study is to identify the neuromuscular control mechanisms that increase MSKI risk following concussion. It is hypothesized that concussed individuals will display abnormal neuromuscular function that increases MSKI risk, as compared to non-concussed controls. The study will employ a multi-center, prospective, case-matched control observational study to identify the differences in neuromuscular function following concussion that may contribute to increased MSKI risk. Once the neuromuscular control mechanisms that increase MSKI risk following concussion are identified, targeted risk mitigation strategies can be developed to reduce MSKI risk.
Description
Musculoskeletal injuries are the greatest unsolved public health problem facing the military and significantly diminish Service member's medical readiness. MSKI affect 800,000 Service members and result in 25 million limited-duty days annually. Additionally, among civilians peers, sport-related MSKI affect as many as 12 million people annually. In total, MSKI place a significant burden on military and civilian populations, with a combined financial burden of more than $980 billion per year in the US alone. Traumatic brain injuries (TBI), specifically concussions a mild form of TBI, have been…
Eligibility
- Age range
- 18–40 years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: Concussed Cohort * 18-40 years old. * Self-reported asymptomatic post-concussion following enrollment into the study and monitoring of symptoms by research personnel via daily self-reported symptom questionnaires. * Recruited within 5 days following being diagnosed with a concussion, and at least 72 hours prior to self-reporting as asymptomatic. * Access to a functional email address and the internet for completion of patient reported outcomes (PROs) and musculoskeletal injury measures. Non-Concussed Cohort * 18-40 years old. * Active duty Service members and physically…
Interventions
- OtherPost-Concussion Neuromuscular Function and Musculoskeletal Injury Risk Assessment
Participants will complete a comprehensive biomechanical and neuromuscular assessments to elucidate the underlying neuromuscular control mechanisms that may contribute to increased MSKI risk following concussion. Participants will also complete a battery of self-report psychosocial measures. Biomechanical Dynamic Movement Assessments: * Jump-Landing * Single Leg Hop * Anticipated Cut * Gait - Single Task * Gait - Dual Task Strength and Voluntary Muscle Activation Assessments: * Interpolated Twitch Technique * Muscular Ramp Contraction Sensory assessments: * Proprioception - Closed Chain * Passive Joint Repositioning * Light Touch Sensation Patient Reported Outcomes: * Self-Reported Musculoskeletal Injuries * National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function * PROMIS Pain Interference * PROMIS Depression * PROMIS Anxiety * Brief Resilience Scale (BRS) * Tampa Scale of Kinesiophobia (TSK-11)
Locations (3)
- University of GeorgiaAthens, Georgia
- Walter Reed National Military Medical CenterBethesda, Maryland
- Womack Army Medical CenterFort Bragg, North Carolina