The relationship between concussion factors and lower extremity injury rates in collegiate athletes

Date
2018
Journal Title
Journal ISSN
Volume Title
Publisher
University of Delaware
Abstract
Background: Athletes with concussions have been shown to have functional postural control and dual tasking deficits long after the traditionally established timeline of clinical recovery. Concern has recently grown over the potential consequences of these deficiencies, and whether or not they adversely impact an athlete’s future risk of injury. Purpose: The purpose of this study was twofold: to retrospectively identify a relationship between sport related concussion (SRC) and subsequent lower extremity (LE) musculoskeletal (MSK) injury in collegiate student-athletes (SA), and identify if concussion presentation characteristics detected through clinical concussion tests at baseline and return to play (RTP) predicted subsequent MSK injury. Methods: Electronic medical records of 24 Division-1 Collegiate Athletic Association (NCAA) SA with a history of SRC were examined and compared to 27 matched control athletes 365 days prior to the date or SRC and 365 days following RTP using a Cox proportional hazard model to calculate an odds ratio for each injury type. Clinical test results were compared to MSK injury risk using a stepwise linear regression model. Results: Within one year of RTP, the study group was 2.95 (95% Confidence Interval (CI), 1.5, 5.78) times more likely than the control group to sustain any MSK injury, 2.09 (95% CI, 1.07, 4.06) times more likely to experience any LE injury, and 2.25 (95% CI, 1.16, 4.36) times more likely to have a LE Non-Contact (NC) injury. The group with concussion was not significantly more likely to sustain a time-loss LE injury (1.86, 95% CI, 0.96, 3.61), a contact LE injury (1.56, 95% CI 0.81, 3.03), a LE overuse injury (1.55, 95% CI, 0.8, 3.02), upper extremity injury (1.67, 95% CI 0.86, 3.25) or general medical complaint (1.78, 95% CI 0.92, 3.46). No relationship was found between increased incidence of MSK injury and any analyzed component of the institutional concussion test battery at baseline or RTP, which included GSC, SAC, BESS, ImPACT, KD, CRT, and TG. Conclusion: These preliminary results suggest SA were at an increased risk of MSK, LE, and LE NC injury in the year following a SRC event, and the current clinical test battery for concussion has no value in predicting this risk of injury. Further research is needed to examine the ability of clinical tests to detect underlying deficits that may be related to increased MSK injury risk.
Description
Keywords
Social sciences, Health and environmental sciences, Education, Athlete, Collegiate, Concussion, Injury, Lower extremity, Sport
Citation