Purpose To quantify the effects of an externally worn collar device for mitigating the influence of repetitive head impacts on alterations to diffusion tensor imaging(DTI)metrics of white matter.Methods Fifteen female...Purpose To quantify the effects of an externally worn collar device for mitigating the influence of repetitive head impacts on alterations to diffusion tensor imaging(DTI)metrics of white matter.Methods Fifteen female high-school soccer athletes(age:14.00-16.98 yrs)completed pre-and post-season DTI over two consecutive years,including measures of diffusivity,changes in which may be associated with brain dysfunction.The collar was worn during year 1(Yr1)but not during year 2(Yr2).Athlete exposures(AEs)and head impact exposure were recorded over the competitive seasons.Results There were no significant differences in AEs or head impact exposures between Yr1 and Yr2(P>0.05).In Yr2,there was significant pre-to post-season mean diffusivity and/or axial diffusivity reduction in multiple WM regions(cor-rected P<0.05).Pre-to post-season mean diffusivity,axial diffusivity,and radial diffusivity decreases were 3.04%±2.53%,2.97%±2.19%,and 3.37%±3.34%,respectively,significantly greater than pre-to post-season changes in Yr1(mean dif-fusivity:-0.31%±1.78%,P=0.0014;axial diffusivity:-0.02%±2.25%,P=0.0014;radial diffusivity:-0.63%±2.10%,P=0.0030).Conclusions Mild bilateral compression to athletes'internal jugular vein through collar application may have increased intracranial blood volume and spatially redistributed head-impact-derived brain energy absorption.However,future research is needed to elucidate the potential clinical significance of WM changes of various degrees.Clinical trails registration NCT03014492.展开更多
Youth athletes are ideal candidates for novel therapeutic motor learning interventions that leverage the plasticity of the central nervous system to promote desirable biomechanical adaptions.We summarize the empirical...Youth athletes are ideal candidates for novel therapeutic motor learning interventions that leverage the plasticity of the central nervous system to promote desirable biomechanical adaptions.We summarize the empirical data supporting the three pillars of the Optimizing Performance Through Intrinsic Motivation and Attention for Learning(OPTIMAL)theory of motor learning and expand on potential neurophysiologic mechanisms that will support enhanced movement mechan-ics in youth to optimize prevention programs for reduced injury risk,injury rehabilitation,exercise performance,and play(Prevention Rehabilitation Exercise Play;PREP).Specifically,we highlight the role of motivational factors to promote the release of dopamine that could accelerate motor performance and learning adaptations.Further,we detail the potential for an external focus of attention to shift attentional allocation and increase brain activity in regions important for sensorimotor integration to facilitate primary motor cortex efficiency.This manuscript serves to provide the most current data in support of the application of OPTIMAL PREP training strategies of the future.展开更多
Youth may be particularly responsive to motor learning training strategies that support injury-resistant movement mechanics in youth for prevention programs that reduce injury risk,injury rehabilitation,exercise perfo...Youth may be particularly responsive to motor learning training strategies that support injury-resistant movement mechanics in youth for prevention programs that reduce injury risk,injury rehabilitation,exercise performance,and play more gener-ally(Optimizing Performance Through Intrinsic Motivation and Attention for Learning Prevention Rehabilitation Exercise Play;OPTIMAL PREP)One purpose of the present manuscript was to provide clinical applications and tangible examples of how to implement the proposed techniques derived from OPTIMAL theory into PREP strategies for youth.A secondary purpose was to review recent advances in technology that support the clinical application of OPTIMAL PREP strategies without extensive resources/programming knowledge to promote evidence-driven tools that will support practitioner feedback delivery.The majority of examples provided are within the context of anterior cruciate ligament(ACL)injury rehabilitation,but we emphasize the potential for OPTIMAL PREP strategies to be applied to a range of populations and training scenarios that will promote injury resistance and keep youth active and healthy.展开更多
There are numerous physical,social,and psychological benefits of exercise,sport and play for youth athletes.However,dynamic activities come with a risk of injury that has yet to be abated,warranting novel therapeutics...There are numerous physical,social,and psychological benefits of exercise,sport and play for youth athletes.However,dynamic activities come with a risk of injury that has yet to be abated,warranting novel therapeutics to promote injury-resistance and to keep an active lifestyle throughout the lifespan.The purpose of the present manuscript was to summarize the extant literature and potential connecting framework regarding youth brain development and neuroplasticity associated with musculoskeletal injury.This review provides the foundation for our proposed framework that utilizes the OPTIMAL(Optimizing Performance Through Intrinsic Motivation and Attention for Learning)theory of motor learning to elicit desir-able biomechanical adaptations to support injury prevention(injury risk reduction),rehabilitation strategies,and exercise performance for youth physical activity and play across all facets of sport(Prevention Rehabilitation Exercise Play;PREP).We conclude that both young male and females are ripe for OPTIMAL PREP strategies that promote desirable movement mechanics by leveraging a unique time window for which their heightened state of central nervous system plasticity is capable of enhanced adaptation through novel therapeutic interventions.展开更多
Purpose Jump-landing assessments provide a means to quantify an individual’s ability to attenuate ground reaction forces,generate lower limb explosive power and maintain joint alignment.In order to identify risk fact...Purpose Jump-landing assessments provide a means to quantify an individual’s ability to attenuate ground reaction forces,generate lower limb explosive power and maintain joint alignment.In order to identify risk factors that can be targeted through appropriate training interventions,it is necessary to establish which(scalar)objective kinetic,kinematic,and performance measures are most associated with lower-extremity injury.Methods Online searches of MEDLINE,SCOPUS,EBSCOHost,SPORTDiscus and PubMed databases were completed for all articles published before March 2020 in accordance with PRISMA guidelines.Results 40 articles investigating nine jump-landing assessments were included in this review.The 79%of studies using drop jump(n=14)observed an association with future injury,while only 8%of countermovement jump studies(n=13)observed an association with injury risk.The 57%of studies using unilateral assessments found associations with risk of injury(n=14).Studies using performance measures(jump height/distance)as outcome measure were only associated with injury risk in 30%of cases.However,those using kinetic and/or kinematic analyses(knee abduction moment,knee valgus angle,knee separation distance,peak ground reaction force)found associations with injury in 89%of studies.Conclusion The landing element of jump-landing assessments appears to be superior for identifying individuals at greater risk of injury;likely due to a closer representation of the injury mechanism.Consequently,jump-landing assessments that involve attenuation of impact forces such as the drop jump appear most suited for this purpose but should involve assessment of frontal plane knee motion and ground reaction forces.展开更多
基金support from National Institutes of Health/NIAMS Grants U01AR067997,R01 AR070474,R01 AR056259-01industry sponsored research funding related to brain injury prevention and assessment with Q30 Innovations,LLC and ElMinda,Ltd,and book royalties from Human KineticsThe other authors have indicated they have no financial relationships relevant to this article to disclose.
文摘Purpose To quantify the effects of an externally worn collar device for mitigating the influence of repetitive head impacts on alterations to diffusion tensor imaging(DTI)metrics of white matter.Methods Fifteen female high-school soccer athletes(age:14.00-16.98 yrs)completed pre-and post-season DTI over two consecutive years,including measures of diffusivity,changes in which may be associated with brain dysfunction.The collar was worn during year 1(Yr1)but not during year 2(Yr2).Athlete exposures(AEs)and head impact exposure were recorded over the competitive seasons.Results There were no significant differences in AEs or head impact exposures between Yr1 and Yr2(P>0.05).In Yr2,there was significant pre-to post-season mean diffusivity and/or axial diffusivity reduction in multiple WM regions(cor-rected P<0.05).Pre-to post-season mean diffusivity,axial diffusivity,and radial diffusivity decreases were 3.04%±2.53%,2.97%±2.19%,and 3.37%±3.34%,respectively,significantly greater than pre-to post-season changes in Yr1(mean dif-fusivity:-0.31%±1.78%,P=0.0014;axial diffusivity:-0.02%±2.25%,P=0.0014;radial diffusivity:-0.63%±2.10%,P=0.0030).Conclusions Mild bilateral compression to athletes'internal jugular vein through collar application may have increased intracranial blood volume and spatially redistributed head-impact-derived brain energy absorption.However,future research is needed to elucidate the potential clinical significance of WM changes of various degrees.Clinical trails registration NCT03014492.
文摘Youth athletes are ideal candidates for novel therapeutic motor learning interventions that leverage the plasticity of the central nervous system to promote desirable biomechanical adaptions.We summarize the empirical data supporting the three pillars of the Optimizing Performance Through Intrinsic Motivation and Attention for Learning(OPTIMAL)theory of motor learning and expand on potential neurophysiologic mechanisms that will support enhanced movement mechan-ics in youth to optimize prevention programs for reduced injury risk,injury rehabilitation,exercise performance,and play(Prevention Rehabilitation Exercise Play;PREP).Specifically,we highlight the role of motivational factors to promote the release of dopamine that could accelerate motor performance and learning adaptations.Further,we detail the potential for an external focus of attention to shift attentional allocation and increase brain activity in regions important for sensorimotor integration to facilitate primary motor cortex efficiency.This manuscript serves to provide the most current data in support of the application of OPTIMAL PREP training strategies of the future.
文摘Youth may be particularly responsive to motor learning training strategies that support injury-resistant movement mechanics in youth for prevention programs that reduce injury risk,injury rehabilitation,exercise performance,and play more gener-ally(Optimizing Performance Through Intrinsic Motivation and Attention for Learning Prevention Rehabilitation Exercise Play;OPTIMAL PREP)One purpose of the present manuscript was to provide clinical applications and tangible examples of how to implement the proposed techniques derived from OPTIMAL theory into PREP strategies for youth.A secondary purpose was to review recent advances in technology that support the clinical application of OPTIMAL PREP strategies without extensive resources/programming knowledge to promote evidence-driven tools that will support practitioner feedback delivery.The majority of examples provided are within the context of anterior cruciate ligament(ACL)injury rehabilitation,but we emphasize the potential for OPTIMAL PREP strategies to be applied to a range of populations and training scenarios that will promote injury resistance and keep youth active and healthy.
文摘There are numerous physical,social,and psychological benefits of exercise,sport and play for youth athletes.However,dynamic activities come with a risk of injury that has yet to be abated,warranting novel therapeutics to promote injury-resistance and to keep an active lifestyle throughout the lifespan.The purpose of the present manuscript was to summarize the extant literature and potential connecting framework regarding youth brain development and neuroplasticity associated with musculoskeletal injury.This review provides the foundation for our proposed framework that utilizes the OPTIMAL(Optimizing Performance Through Intrinsic Motivation and Attention for Learning)theory of motor learning to elicit desir-able biomechanical adaptations to support injury prevention(injury risk reduction),rehabilitation strategies,and exercise performance for youth physical activity and play across all facets of sport(Prevention Rehabilitation Exercise Play;PREP).We conclude that both young male and females are ripe for OPTIMAL PREP strategies that promote desirable movement mechanics by leveraging a unique time window for which their heightened state of central nervous system plasticity is capable of enhanced adaptation through novel therapeutic interventions.
文摘Purpose Jump-landing assessments provide a means to quantify an individual’s ability to attenuate ground reaction forces,generate lower limb explosive power and maintain joint alignment.In order to identify risk factors that can be targeted through appropriate training interventions,it is necessary to establish which(scalar)objective kinetic,kinematic,and performance measures are most associated with lower-extremity injury.Methods Online searches of MEDLINE,SCOPUS,EBSCOHost,SPORTDiscus and PubMed databases were completed for all articles published before March 2020 in accordance with PRISMA guidelines.Results 40 articles investigating nine jump-landing assessments were included in this review.The 79%of studies using drop jump(n=14)observed an association with future injury,while only 8%of countermovement jump studies(n=13)observed an association with injury risk.The 57%of studies using unilateral assessments found associations with risk of injury(n=14).Studies using performance measures(jump height/distance)as outcome measure were only associated with injury risk in 30%of cases.However,those using kinetic and/or kinematic analyses(knee abduction moment,knee valgus angle,knee separation distance,peak ground reaction force)found associations with injury in 89%of studies.Conclusion The landing element of jump-landing assessments appears to be superior for identifying individuals at greater risk of injury;likely due to a closer representation of the injury mechanism.Consequently,jump-landing assessments that involve attenuation of impact forces such as the drop jump appear most suited for this purpose but should involve assessment of frontal plane knee motion and ground reaction forces.
