How do the neck muscles influence head acceleration during sport-associated impact events in high school athletes?

颈部肌肉如何影响高中运动员在运动相关冲击事件中的头部加速度？

• 批准号: 10213102
• 负责人: James Travis Eckner
• 金额: $ 59.38万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-28 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10213102
• 关键词: Acceleration; Affect; Attenuated; Brain Concussion; Cervical; Child; Clinical Trials; Control Groups; Data; Dose; Epidemiology; Event; Exercise; Female; Goals; Head; Health; Injury; Intervention; Investigation; Knowledge; Laboratories; Lead; Long-Term Effects; Manuals; Mission; Morbidity - disease rate; Muscle; Neck; Pilot Projects; Play; Population; Prevention; Protocols documentation; Publishing; Research; Resistance; Risk; Shoulder; Side; Skeletal muscle structure of neck; Soccer; Sports; Statistical Models; Volition; Work; Youth; base; blind; college; disability; epidemiology study; evidence base; exercise intensity; exercise intervention; exercise prescription; exercise program; experience; head impact; high risk; high school; improved; insight; male; muscle hypertrophy; muscle stiffness; neuromuscular; prevent; prospective; recruit; resistance exercise; response; sex; student athlete; translational impact

PROJECT SUMMARY/ABSTRACT Sport-related concussion is a common and serious injury in the ~7.8 million student-athletes who compete at the high school level each year in the U.S. A successful strategy for reducing the risk of concussion and its associated adverse short- and long-term consequences in this population would advance the mission of enhancing health, reducing illness and disability, and promoting children’s chances to achieve their full potential for healthy and productive lives. Neck strengthening exercise may represent such an intervention. Athletes with smaller, weaker necks are thought to be at increased risk for concussion because their necks are less able to counter the forces acting on their heads during sport-associated collisions, leading to greater resultant net head accelerations. However, our understanding of the mechanism governing the neck’s influence over head acceleration remains incomplete, and the potential for this relationship to be modified by exercise remains unclear. These questions must be answered before neck strengthening exercise programs can be optimized to reduce athletes’ risk of concussion. The proposed mechanistic prospective clinical trial will pursue the following specific aims: AIM 1) to determine the effect of manual resistance neck strengthening exercise on neck strength, cervical muscle volume, and net head acceleration under multiple simulated sport- associated impact conditions; AIM 2) to determine the relative influences of neck strength and cervical muscle volume on net head acceleration during simulated sport-associated impacts to the head and body, with and without volitional anticipatory cervical muscle pre-contraction to brace for the impact. The approach to AIM 1 will be to serially reassess the effects of a low or high intensity manual resistance neck strengthening exercise program on key cervical muscle attributes and net head acceleration under each impact condition. Assessments will be performed in 108 high school athletes at baseline and upon completion of 4, 8, and 12 weeks of the exercise intervention, with comparison to a control group participating in a “shoulders-down” exercise program not specifically targeting the neck. The approach to AIM 2 will be to compare the R2 values of statistical models using baseline data collected with and without anticipatory cervical muscle pre-contraction to predict net head acceleration based on either neck strength, cervical muscle volume, or both. This research is expected to establish dose-response relationships for manual resistance neck strengthening exercise on neck strength, cervical muscle volume, and net head acceleration, as well as define the mechanism by which the neck controls head acceleration during impacts to the head and body with and without anticipatory cervical muscle pre-contraction to brace for the impact. This work will provide important mechanistic insight about how the cervical muscles resist head acceleration that will ultimately lead to improved neck strengthening exercise programs for athletes. In doing so, this work will contribute to the long term objective of reducing concussion- related morbidity through the prescription of neck strengthening exercise.

项目摘要/摘要 与体育有关的咨询是约780万名学生运动员的常见且严重的伤害 美国每年的高中级 相关的不利短期和长期后果将推进使命 改善健康，减少疾病和残疾，并促进儿童实现自己的机会 健康和产品生命的潜力。颈部加强运动可能代表这种干预措施。 人们认为脖子较小，脖子较弱，脖子较弱的运动员，因为他们的脖子是 在体育相关的碰撞期间，无法应对在其头上行动的力量的能力，导致更大 结果净头加速度。但是，我们对管理脖子的机制的理解 对头部加速度的影响仍然不完整，并且这种关系的可能性被修改 运动尚不清楚。这些问题必须在加强颈部锻炼计划之前回答 可以优化以减少运动员的咨询风险。拟议的机械前瞻性临床试验将 追求以下特定目的：目标1）确定手动阻力颈部的效果 在多个模拟运动中进行颈部强度，颈肌体积和净头加速度运动 - 相关的影响条件；目标2）确定颈部强度和宫颈肌肉的相对影响 在模拟体育相关的对头部，身体的影响期间，净头部加速度的体积 没有自愿的预期宫颈肌肉预算来支撑撞击。目标1 将连续重新评估低强度或高强度手动阻力颈部增强运动的影响 在每个影响条件下，有关关键宫颈肌肉属性和净头加速度的计划。 评估将在基线时在108名高中运动员中进行，并在4、8和12完成后进行评估。 与参加“肩膀”的对照组相比，运动干预数周 锻炼计划不是专门针对脖子的。目标2的方法是比较R2值 使用有或没有预期性宫颈肌肉预防的基线数据的统计模型 预测基于颈部强度，颈肌体积或两者兼而有之的净头加速度。这项研究 有望建立手动阻力颈部增强运动的剂量反应关系 颈部强度，宫颈肌肉体积和净头加速度，并定义了该机制 颈部控制头部加速在对头部和身体的撞击期间，没有预期的宫颈 肌肉预屈服以支撑撞击。这项工作将提供有关如何 宫颈肌肉抵抗头部加速度，最终会改善颈部增强运动 运动员的计划。为此，这项工作将有助于减少咨询的长期目标 - 通过处方颈部加强运动相关的发病率。