ORTHOPEDICS THIS WEEK VOLUME 14 , ISSUE 23 | JULY 17 , 2018 25 season and postseason and head impact was recorded using the GForce Tracker accelerometer device attached to the inside of each football helmet . In addition , differences in whole brain axial diffusivity ( AD ), a measure of WM integrity based on diffusion tensor imaging , and total impacts , between HS and YFB at preseason and postseason were recorded .
According to the data , the HS group had more total head impacts compared to the YFB group ( p < . 001 ). In high school football athletes , significant pre- to postseason AD reduction ( p < 0.05 , corrected ) was found in extensive WM areas .
The percentage of AD reduction within these significant area WM areas in the HS group ( 2.43 ± 1.01 %) was significantly greater than the YFB group ( 0.37 ± 1.27 %, t = 5.13 , df = 31 , p < 0.0001 ). Significant pre- to post-season AD reduction was also found in the YFB group ( p < 0.05 , corrected ) but was limited in size of the regions . Within these areas , the percentage of AD reduction in the YFB group ( 3.35 ± 1.58 %) was significantly greater than the HS group ( 0.50 ± 2.84 %, t = 3.71 , df = 31 , p = 0.0008 ).
One limitation to the study is the sample size . Future studies are needed to investigate the age dependence ( e . g . myelination ) and region specific vulnerability of WM to head impact exposure in concussion and should include data over multiple seasons with a larger sample size .
“ The biggest take away was that our data did not confirm the current speculation that younger children are more susceptible to negative effects of repetitive head impacts when compared to older adolescents ,” Foss told OTW .
She added , “ We shouldn ’ t necessarily stop kids from playing a sport as exercise is very important , but we should focus on reducing exposure to head impacts . Having access to athletic trainers and sports medicine doctors is key , both in helping to support injury prevention , but also fully rehabilitating an injured athlete before being allowed to return to sport .” — TR
Concussion : Dual- Task Gait Linked to Future Injury Risk
At the recent National Athletic Trainers ’ Association ’ s ( NATA ) 69th Clinical Symposia & AT Expo , held in New Orleans between June 26 and June 28 , 2018 , one of the new studies presented suggests that studying dual-task gait after a concussion can shed light on future injury risk .
To study dual-task gait outcomes , David Howell , Ph . D ., ATC and colleagues evaluated 41 athletes within the first 21 days of concussion and again when they were deemed clinically recovered . The study protocol included a symptom inventory and instrumented dualtask gait evaluation , where they walked and completed a cognitive task ( months backward , serial 7s backward , or spelling words backwards ) while wearing an instrumented sensor system .
And then approximately one year postconcussion , they were asked to report any acute sport-related injury since returning to sports .
According to the data , the group who went on to sustain an acute injury ( n = 15 ; 38 %) demonstrated significant average walking speed dualtask cost worsening across time ( p = 0.005 ). In contrast , the group who did not sustain an injury walked with similar dual-task cost values at both time points ( p = 0.45 ). In addition , symptoms improved for all participants ( p = 0.78 ).
There were several limitations to the study including the fact that the questionnaire used to assess the injuries by participants in the year following their concussion was not validated against an existing metric and that neither clinical balance nor neurocognitive data were available .
Howell told OTW , “ There were many challenging aspects to the study , but the most important was trying to contact people one year after their injury to assess whether or not they had sustained a concussion . We were able to successfully contact 42 individuals , but this only represented 61 % of our participant sample .”
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