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1.
This review presents a conceptual framework and supporting evidence that links impaired motor control after sport-related concussion (SRC) to increased risk for musculoskeletal injury. Multiple studies have found that athletes who are post-SRC have higher risk for musculoskeletal injury compared to their counterparts. A small body of research suggests that impairments in motor control are associated with musculoskeletal injury risk. Motor control involves the perception and processing of sensory information and subsequent coordination of motor output within the central nervous system to perform a motor task. Motor control is inclusive of motor planning and motor learning. If sensory information is not accurately perceived or there is interference with sensory information processing and cognition, motor function will be altered, and an athlete may become vulnerable to injury during sport participation. Athletes with SRC show neuroanatomic and neurophysiological changes relevant to motor control even after meeting return to sport criteria, including a normal neurological examination, resolution of symptoms, and return to baseline function on traditional concussion testing. In conjunction, altered motor function is demonstrated after SRC in muscle activation and force production, movement patterns, balance/postural stability, and motor task performance, especially performance of a motor task paired with a cognitive task (i.e., dual-task condition). The clinical implications of this conceptual framework include a need to intentionally address motor control impairments after SRC to mitigate musculoskeletal injury risk and to monitor motor control as the athlete progresses through the return to sport continuum.  相似文献   
2.
BackgroundConsidering the potential cumulative effects of repetitive head impact (HI) exposure, we need sensitive biomarkers to track short- and long-term effects. Circulating small extracellular vesicles (sEVs) (<200 nm) traffic biological molecules throughout the body and may have diagnostic value as biomarkers for disease. The purpose of this study was to identify the microRNA (miRNA) profile in circulating sEVs derived from human plasma following repetitive HI exposure.MethodsHealthy adult (aged 18–35 years) soccer players were randomly assigned to one of 3 groups: the HI group performed 10 standing headers, the leg impact group performed 10 soccer ball trapping maneuvers over 10 min, and the control group did not participate in any soccer drills. Plasma was collected before testing and 24 h afterward, and sEVs were isolated and characterized via nanoparticle tracking analysis. Next-generation sequencing was utilized to identify candidate miRNAs isolated from sEVs, and candidate microRNAs were analyzed via quantitative polymerase chain reaction. In silico target prediction was performed using TargetScan (Version 7.0; targetscan.org) and miRWalk (http://mirwalk.umm.uni-heidelberg.de/) programs, and target validation was performed using luciferase reporter vectors with a miR-7844-5p mimic in human embryonic kidney (HEK) 293T/17 cells.ResultsPlasma sEV concentration and size were not affected across time and group following repetitive HI exposure. After 24 h, the HI read count from next-generation sequencing showed a 4-fold or greater increase in miR-92b-5p, miR-423-5p, and miR-24-3p and a 3-fold or greater decrease in miR-7844-5p, miR-144-5p, miR-221-5p, and miR-22-3p. Analysis of quantitative polymerase chain reaction revealed that leg impact did not alter the candidate miRNA levels. To our knowledge, miR-7844-5p is a previously unknown miRNA. We identified 8 miR-7844-5p mRNA targets: protein phosphatase 1 regulatory inhibitor subunit 1B (PPP1R1B), LIM and senescent cell antigen-like domains 1 (LIMS1), autophagy-related 12 (ATG12), microtubule-associated protein 1 light chain 3 beta (MAP1LC3B), integrin subunit alpha-1 (ITGA1), mitogen-activated protein kinase 1 (MAPK1), glycogen synthase kinase 3β (GSK3β), and mitogen-activated protein kinase 8 (MAPK8).ConclusionCollectively, these data indicate repetitive HI exposure alters plasma sEV miRNA content, but not sEV size or number. Furthermore, for the first time we demonstrate that previously unknown miR-7844-5p targets mRNAs known to be involved in mitochondrial apoptosis, autophagy regulation, mood disorders, and neurodegenerative disease.  相似文献   
3.
The objective was to investigate the relationship between IL-1B rs16944, IL-6 rs1800795, and CASP8 rs3834129 genetic polymorphisms and concussion severity. Rugby players from high school, senior amateur, and professional teams completed a concussion severity questionnaire and donated a DNA sample. Participants (n = 163) were split into symptom severity groups around the median number and duration of symptoms. The frequency of participants with high symptom counts (more than five symptoms) increased across the IL-1B (C/C: 35%; C/T: 51%; T/T: 56%; P = 0.047) and the IL-6 (C/C: 31%; C/G: 44%; G/G: 58%; P = 0.027) genotypes. The C–C inferred interleukin allele construct frequency, created from combining the IL-1B and IL-6 genotype data, was lower in participants reporting a high symptom count (18%), compared to those with a low symptom count (fewer than six symptoms, 36%, P = 0.002). Similarly, the C–C inferred interleukin allele construct frequency was lower in those reporting prolonged symptom duration (more than one week, 16%), as opposed to short symptom duration (less than one week, 34%, P = 0.015). This study provides evidence of novel inflammatory pathway genetic associations with concussion severity, which supports the hypothesis implicating neuroinflammation in the development of concussion symptoms.  相似文献   
4.
目的:探讨依达拉奉结合其他常规西医治疗脑震荡临床疗效。方法:对98例脑震荡患者随机分为3组,常规西医治疗组,依达拉奉结合常规西医治疗组,纯中医治疗组。结果:通过临床观察、总结,依达拉奉结合常规西医治疗组临床疗效明显优于对照组,差异有统计学意义(P<0.05)。结论:依达拉奉结合常规西医治疗脑震荡疗程短,疗效佳,不良反应少,值得临床推广。  相似文献   
5.
Player-to-player contact inherent in many unhelmeted sports means that head impacts are a frequent occurrence. Model-Based Image-Matching (MBIM) provides a technique for the assessment of three-dimensional linear and rotational motion patterns from multiple camera views of a head impact event, but the accuracy is unknown for this application. The goal of this study is to assess the accuracy of the MBIM method relative to reflective marker-based motion analysis data for estimating six degree of freedom head displacements and velocities in a staged pedestrian impact scenario at 40 km/h. Results showed RMS error was under 20 mm for all linear head displacements and 0.01–0.04 rad for head rotations. For velocities, the MBIM method yielded RMS errors between 0.42 and 1.29 m/s for head linear velocities and 3.53–5.38 rad/s for angular velocities. This method is thus beneficial as a tool to directly measure six degree of freedom head positional data from video of sporting head impacts, but velocity data is less reliable. MBIM data, combined in future with velocity/acceleration data from wearable sensors could be used to provide input conditions and evaluate the outputs of multibody and finite element head models for brain injury assessment of sporting head impacts.  相似文献   
6.
The purpose of this study was to determine if a relationship exists between purposeful heading in soccer and neuropsychological test performance. Automated Neuropsychological Assessment Metrics throughput scores were derived on seven subset variables that measure a variety of neurocognitive abilities. Simple Spearman's rank correlations were calculated between headers per game (HPG) and the criterion variables. Interestingly, math processing speed (Spearman's rho = .160) and continuous performance test #2 (rho = .124) had small but significant correlations; both showed improvement in performance pre- to postseason. There were no significant correlations between HPG and the other five variables. This study found no detrimental relationship between the number of purposeful headers and the neurocognitive measures in this population.  相似文献   
7.
Abstract

Limited data are available on the active and sedentary behaviours of young people in Eastern Europe. Hungary, Romania, and Slovakia are relatively new members of the European Union. The socioeconomic status of the people of these countries differs from that of their Western European counterparts. These three countries are understudied in respect of physical activity and sedentary behaviour patterns in youth. Ecological momentary assessment was employed for data collection among 13- to 18-year-old students (n=623). A 3 (socioeconomic status)×3 (country)×2 (gender) multivariate analysis of variance, with physical activity, technological sedentary behaviour, and sedentary socializing behaviour as dependent variables, showed that for weekday behaviours there were significant multivariate main effects for country (P<0.001) and gender (P<0.001), but not for socioeconomic status (P>0.05). Slovakia showed greater technological sedentary behaviours than the other two countries. Romania and Slovakia had higher physical activity levels than Hungary. Boys spent more time than girls on technological sedentary behaviours, while girls spent more time than boys on socializing sedentary behaviours on weekdays and weekends (P<0.001). For weekend behaviours, the country×gender interaction was significant (P<0.046), with the highest rates of technological sedentary behaviours for males in Slovakia and Hungary, with lower figures for girls in these countries and particularly for boys and girls in Romania. There was a significant multivariate main effect for country (P<0.001), with fewer technological sedentary behaviours in Romania than the other two countries. Hungarian youth were less active than Romanian youth. These three Eastern European countries show quite high levels of sedentary behaviours but these co-exist with varying physical activity patterns. Values differ by country and gender.  相似文献   
8.
Background: There is a high incidence of concussion sustained by athletes participating in rugby union, many of which go unreported. A lack of sufficient knowledge about concussion injuries may explain athletes’ failure to report. Several rugby union-playing countries have developed injury education and prevention programmes to address this issue. Objective: The aim of the current review was to systematically assess the content and level of evidence on concussion education/prevention programmes in rugby union and to make recommendations for the quality, strength, and consistency of this evidence. Methods: We searched PubMed, PsycInfo, MEDLINE, SPORTDiscuss, Webofscience, and conducted a manual search for articles. Results: Ten articles were included for review. Of these, six focused on the BokSmart injury prevention programme in South Africa, two focused on the RugbySmart injury prevention programme in New Zealand, one was an analysis of prevention programmes, and one was a systematic review of rugby injury prevention strategies. Conclusions: Despite the initiative to develop concussion education and prevention programmes, there is little evidence to support the effectiveness of such programmes. There is evidence to support education of coaches and referees. In addition, there is scant evidence to suggest that education and rule changes may have the benefit of changing athlete behaviours resulting in a reduction in catastrophic injury.  相似文献   
9.
The objective of this study was to explore beliefs and attitudes of students studying exercise science in Australia towards sports concussion. A secondary objective explored differences between gender and previous experience of concussion. A total of 312 participants (m = 217; f = 95) responded to a series of statements ranging across a number of areas including personal attitudes and beliefs towards concussion: if they would risk playing with a concussion; their views on elite/professional athletes who continue to play after a concussion; and attitudes towards rehabilitation. Overall, attitudes revealed that it was not safe to play with a concussion, and it was believed that those who have had repeated concussions would be likely to suffer problems later in life. However, responses also indicated that they would risk playing with a concussion, and admired elite athletes who continued to play. When controlling for gender and previous concussions, males and those who sustained a previous concussion/s were more likely to continue playing. Conversely, females were more likely to complete rehabilitation prior to returning to sport. This study demonstrates in an Australian student cohort studying for a career in exercise and sports science, disparity between beliefs and attitudes regarding sports concussion.  相似文献   
10.
Although experts have noted that adolescent athletes should be educated about concussions to improve their safety, there is no agreement on the most effective strategy to disseminate concussion education. The purpose of this study was to develop, implement and assess a concussion education programme. More precisely, four interactive oral presentations were delivered to high school student-athletes (= 35, Mage = 15.94, SD = 0.34) in a large urban centre. Participants completed a questionnaire at three time-points during the season to measure changes in their knowledge (CK) and attitudes (CA) of concussions, and focus group interviews were conducted following the concussion education programme. Questionnaire data revealed participants’ post-intervention CK scores were higher than their pre-intervention scores. During the focus groups, the student-athletes said they acquired CK about the role of protective equipment and symptom variability, and in terms of CA, they intended to avoid dangerous in-game collisions in the future. Our study was the first to create and deliver a concussion education intervention across multiple time-points, and to use mixed-methods in its assessment. These findings may be of interest to researchers, practitioners and stakeholders in sport who are invested in making the sport environment safer through concussion education and awareness.  相似文献   
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