Kiefer, AW; DiCesare, C; Nalepka, P; Foss, KB; Thomas, S; Myer, GD. Less efficient oculomotor performance is associated with increased incidence of head impacts in high school ice hockey. Journal of Science and Medicine in Sport. 2018; 21(1):4-9.
Implicated as the most common injury mechanism in boys ice hockey is player to player contact at both the amateur and elite levels. This type of injury accounts for 51% of all injuries and 70 % of concussion injuries across all contact- and collision-based sports. Vision plays a preparatory role in collision avoidance and allows for the prospective control of avoidance maneuvers. Collision avoidance behavior is dependent on both attention to, and rapid switching among, various opponents and objects to quickly process the visual scene. In the current study, we prospectively evaluated oculomotor performance on a variety of visual tasks and examined whether this performance associates to head impacts during the competitive season. Our data indicates that less efficient oculomotor performance associates with increased incidence of head impacts and provide an important first step toward understanding strategies to reduce incidence of injury risk in ice hockey, and potentially contact sports more generally.
Kiefer, A; DiCesare, C; Bonnette, S; Kitchen, K; Gadd, B; Thomas, S; Foss, K; Myer, G; Riley, M; Silva, P; IEEE. Sport-Specific Virtual Reality to Identify Profiles of Anterior Cruciate Ligament Injury Risk During Unanticipated Cutting. IEEE. 2017; 2017-June.
Female athletes are at an increased risk of anterior cruciate ligament (ACL) injury in competitive sport during running, jumping and cutting tasks. Implementation of targeted neuromuscular interventions works to reduce previously identified injury risk factors. However, despite the successful modification of ACL injury risk factors following such interventions, the transfer of these corrected movement patterns to sport-specific contexts has not been directly evaluated. Sport-specific virtual reality (VR) may provide the best method to measure training transfer to realistic sport performance, while still allowing appropriate experimental control and high-fidelity performance measurements. Our data indicated that, following participation in a neuromuscular-based ACL injury risk reduction intervention, athletes exhibited a significant reduction in internal hip rotation (a primary ACL injury risk factor) during both the loading and push-off phase of an unanticipated cut in response to a VR-based soccer defense task. This study is the first to assess injury risk in a free ambulatory wireless VR sport scenario and the results are first step in the validation of sport-specific VR as a tol for understanding injury risk during simulation of real-world sport performance.
Yuan, W; Barber Foss, KD; Thomas, S; DiCesare, CA; Dudley, JA; Kitchen, K; Gadd, B; Leach, JL; Smith, D; Altaye, M; Gubanich, P; Galloway, RT; McCrory, P; Bailes, JE; Mannix, R; Meehan, WP 3rd; Myer, GD. White matter alterations over the course of two consecutive high-school football seasons and the effect of a jugular compression collar: A preliminary longitudinal diffusion tensor imaging study. Human Brain Mapping. 2018; 39(1):491-508.
This study was the first longitudinal prospective neuroimaging study evaluating brain WM alterations in response to repetitive head impact and the potential protection effect of a jugular vein compression neck collar device over the course of two consecutive high school football seasons. In both season one and season two, we demonstrated significant or at least trend-level reduction in diffusivity in a series of important WM regions in athletes without the collars, suggesting the effect of repetitive head impact experienced during competitive football season on the structural integrity of WM in the brain network. Researchers found some of the WM abnormalities recover partially during the off-season but they remained significantly abnormal when tested prior to the beginning of season two, indicating the persistent nature of the WM structural alteration despite the eight to nine-month long impact-free off-season. By contrast, WM integrity based on DTI remained constant in the collar group throughout the time over the two competitive football seasons despite comparable impact exposure. These results provide strong evidences to support the notion that the collar device might represent a piece of protective equipment that could reduce the risk of long-term sequelae resulting from sub-concussive impacts.
Paterno, MV; Flynn, K; Thomas, S; Schmitt, LC. Self-Reported Fear Predicts Functional Performance and Second ACL Injury After ACL Reconstruction and Return to Sport: A Pilot Study. Sports Health: A Multidisciplinary Approach. 2018; 10(3):228-233.
Wide variation persists in outcome after anterior cruciate ligament (ACL) reconstruction in young athletes as many fail to return to pre-injury level of activity and as many as 33% suffer a second ACL injury within two years of return to activity. Current criteria used to determine readiness to return to sport focus on measures of strength and functional performance, but they are failing to identify patients ready to safely return to activity. Assessment of one metric after ACL reconstruction is patient self-reported fear of movement and reinjury, but these measures are not yet linked to future outcome. This study assessed patient reported fear at the time of return to sport and found that higher fear associates with decreased activity, decreased strength and function and a higher risk of suffering a second ACL injury on the same knee. Self-reported fear of movement and reinjury at the time of return to sport after ACL reconstruction may be an important measure to incorporate into a discharge criteria prior to release to return to sports after ACL reconstruction.
Kiefer, AW; DiCesare, C; Nalepka, P; Foss, KB; Thomas, S; Myer, GD. Less efficient oculomotor performance is associated with increased incidence of head impacts in high school ice hockey. Journal of Science and Medicine in Sport. 2018; 21(1):4-9.
Approximately four million sport-related injuries occur per year, accounting for 2.6 million emergency department visits and upwards of two billion in costs, resulting in the need for preventative strategies such as neuromuscular training programs targeted toward the female adolescent athletes. Researchers took 474 female middle and high school volleyball, soccer, and basketball players and randomized them to either a CORE intervention, which consisted of trunk and lower extremity focused exercises, or a SHAM intervention, consisting of resistance band running, implemented at practices during their competitive sports season. Results indicated that overall, the CORE group sustained less injuries than the SHAM group. Across levels, both levels had less injuries in the CORE group than the SHAM group and across sports, the CORE group resulted in less injuries at the high school basketball level and specifically within the CORE group, knee injuries were the most reduced at the middle school level. Participation in an injury prevention program focused on trunk and lower extremity exercises yielded a protective benefit for both high school and middle school female athletes.