학술논문

Lower-Extremity Neuromuscular Function Following Concussion: A Preliminary Examination.
Document Type
Article
Source
Journal of Sport Rehabilitation. Jan2023, Vol. 32 Issue 1, p31-39. 9p. 2 Charts, 2 Graphs.
Subject
*LEG physiology
*SKELETAL muscle physiology
*MUSCULOSKELETAL system injuries
*MATHEMATICAL statistics
*NONPARAMETRIC statistics
*STATISTICS
*NEUROPHYSIOLOGY
*SMOOTH muscle
*PHOBIAS
*SENSORIMOTOR integration
*MUSCLE contraction
*PARAMETERS (Statistics)
*CONFIDENCE intervals
*BODY weight
*SAMPLE size (Statistics)
*STATISTICAL reliability
*FUNCTIONAL status
*CROSS-sectional method
*SELF-evaluation
*EFFECT sizes (Statistics)
*NEUROMUSCULAR system
*HEALTH outcome assessment
*MANN Whitney U Test
*POSTCONCUSSION syndrome
*BRAIN concussion
*HOSPITAL laboratories
*BODY movement
*ELECTRIC stimulation
*DESCRIPTIVE statistics
*INTRACLASS correlation
*SCALE analysis (Psychology)
*DATA analysis
*DATA analysis software
*STATISTICAL sampling
*LONGITUDINAL method
*SOMATOSENSORY disorders
*DISEASE complications
Language
ISSN
1056-6716
Abstract
Context: Neuromuscular function is altered acutely following concussion and theoretically linked to the subsequent postconcussion musculoskeletal injury risk. Existing research has only examined voluntary muscle activation, limiting mechanistic understanding. Therefore, our study aimed to examine voluntary and involuntary muscle activation between college-aged, concussed individuals when symptom-free and healthy matched controls. Design: Prospective, cross-sectional cohort laboratory study. Methods: Concussed and healthy participants (n = 24; 58% male, age: 19.3 [1.1] y, mass: 70.3 [16.4] kg, height: 177.3 [12.7] cm) completed the superimposed burst (SB) neuromuscular assessment on their dominant limb within 72 hours after self-reporting asymptomatic (22.4 [20.2] d postinjury). Unnormalized and bodyweight-normalized quadriceps maximal voluntary isometric contraction torque (in newton meters), unnormalized and bodyweight-normalized electrically stimulated SB torque, pain (numeric 1–10) during SB, and the central activation ratio (in percentage) were assessed via the SB. Parametric and nonparametric analyses, 95% confidence intervals (95% CIs), and Hedges g (parametric) and Spearman ρ (nonparametric) effect sizes were used to examine group differences (α =.05). Results: The maximal voluntary isometric contraction torque (concussed: 635.60 N·m [300.93] vs control: 556.27 N·m [182.46]; 95% CI, −131.36 to 290.02; P =.443; d = 0.33), SB torque (concussed: 203.22 N·m [97.17], control: 262.85 N·m [159.07]; 95% CI, −171.22 to 51.97; P =.280; d = −0.47), and central activation ratio (concussed: 72.16% [17.16], control: 70.09% [12.63]; 95% CI, −10.68 to 14.83; P =.740; d = 0.14) did not differ between the concussed and control groups regardless of bodyweight normalization (P ≥.344). Pain during the SB was significantly higher with a medium effect for participants with a concussion versus healthy controls (concussed: median = 7, control: median = 5; P =.046; ρ = −0.42). Discussion: These findings suggest concussed participants do not have statistically altered voluntary or involuntary quadricep neuromuscular function once asymptomatic compared with controls. Therefore, the elevated postconcussion musculoskeletal injury risk may not be attributed to lower-extremity muscle activation. Concussed participants displayed greater pain perception during the SB, which suggests somatosensory or perception changes requiring further examination. [ABSTRACT FROM AUTHOR]