Self-reported concussion history and sensorimotor tests predict head/neck injuries

Journal article

Hides, Julie Anne, Franettovich Smith, Melinda M., Mendis, M Dilani, Treleaven, Julia, Rotstein, Andrew H., Sexton, Christopher T., Low Choy, Nancy and McCrory, Paul. (2017). Self-reported concussion history and sensorimotor tests predict head/neck injuries. Medicine and Science in Sports and Exercise. 49(12), pp. 2385-2393. https://doi.org/10.1249/MSS.0000000000001372
AuthorsHides, Julie Anne, Franettovich Smith, Melinda M., Mendis, M Dilani, Treleaven, Julia, Rotstein, Andrew H., Sexton, Christopher T., Low Choy, Nancy and McCrory, Paul
Abstract

Sports related concussion (SRC) is a risk for players involved in high impact, collision sports. A history of SRC is a risk factor for future concussions, but the mechanisms underlying this are unknown. Despite evidence that most visible signs and symptoms associated with sports concussion resolve within 7-10 days, it has been proposed that subclinical loss of neuromuscular control and impaired motor functioning may persist and be associated with further injury. Alternatively, indicators of poor sensorimotor performance could be independent risk factors. This study investigated if a history of SRC and/or pre-season sensorimotor performance predicted season head/neck injuries. Methods: 190 male rugby league, rugby union and Australian Football League players participated. Pre-season assessments included self-report of SRC within the previous 12 months and a suite of measures of sensorimotor function (balance, vestibular function, cervical proprioception and trunk muscle function). Head/neck injury data were collected in the playing season. Results: Forty-seven players (25%) reported a history of SRC. A history of concussion was related to changes in size and contraction of trunk muscles. Twenty-two (11.6%) players sustained a head/neck injury during the playing season, of which, 14 (63.6%) players had a previous history of SRC. Predictors of in-season head/neck injuries included history of SRC, trunk muscle function and cervical proprioceptive errors. Five risk factors were identified and players with three or more of these had 14 times greater risk of sustaining a season neck/head injury (sensitivity of 75% and specificity of 82.5%) than players with 2 or fewer risk factors. Conclusion: The modifiable risk factors identified could be used to screen football players in the pre-season and guide development of exercise programs aimed at injury reduction.

Keywordsfootball; proprioception; risk factors; rugby; trunk muscles
Year2017
JournalMedicine and Science in Sports and Exercise
Journal citation49 (12), pp. 2385-2393
ISSN0195-9131
Digital Object Identifier (DOI)https://doi.org/10.1249/MSS.0000000000001372
Scopus EID2-s2.0-85023738528
Open accessOpen access
Page range2385-2393
Research GroupMary MacKillop Institute for Health Research
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Lumbar multifidus muscle size is associated with lower limb overuse injuries in military specialist trainees
Crowley, Geoff, Creaby, Mark, Neill, Sharne, Hides, Julie and Smith, Melinda. (2012). Lumbar multifidus muscle size is associated with lower limb overuse injuries in military specialist trainees. Australian Military Medicine Conference. Australia: Australian Military Medicine Association. pp. 60 - 61
Abdominal muscle response to a simulated weight-bearing task by elite Australian Rules football players
Hyde, J A., Stanton, W R. and Hides, Julie A.. (2012). Abdominal muscle response to a simulated weight-bearing task by elite Australian Rules football players. Human Movement Science. 31, pp. 129 - 138. https://doi.org/10.1016/j.humov.2011.04.005
The relationship of transversus abdominis and lumbar multifidus clinical muscle tests in patients with chronic low back pain
Hides, Julie Anne, Stanton, Warren Robert, Mendis, M. Dilani and Sexton, Margot. (2011). The relationship of transversus abdominis and lumbar multifidus clinical muscle tests in patients with chronic low back pain. Manual Therapy (online version). 16(6), pp. 573 - 577. https://doi.org/10.1016/j.math.2011.05.007
Muscle atrophy and changes in spinal morphology :Is the lumbar spine vulnerable after prolonged bed-rest?
Belavy, Daniel, Armbrecht, Gabriele, Richardson, Carolyn, Felsenberg, Dieter and Hides, Julie. (2011). Muscle atrophy and changes in spinal morphology :Is the lumbar spine vulnerable after prolonged bed-rest? Spine. 36(2), pp. 137 - 145. https://doi.org/10.1097/BRS.0b013e3181cc93e8
Screening the lumbopelvic muscles for a relationship to injury of the quadriceps, hamstrings, and adductor muscles among elite Australian football league players
Hides, Julie Anne, Brown, Cassandra, Penfold, Lachlan and Stanton, Warren Robert. (2011). Screening the lumbopelvic muscles for a relationship to injury of the quadriceps, hamstrings, and adductor muscles among elite Australian football league players. Journal of Orthopaedic and Sports (online version). 41(10), pp. 767 - 775. https://doi.org/10.2519/jospt.2011.3755
The effects of rehabilitation on the muscles of the trunk following prolonged bed rest
Hides, Julie Anne, Lambrecht, G., Richardson, C A., Stanton, W., Armbrecht, G., Pruett, C., Damann, V., Felsenberg, D. and Belavy, D.. (2011). The effects of rehabilitation on the muscles of the trunk following prolonged bed rest. European Spine Journal (online version). 20(5), pp. 808 - 818. https://doi.org/10.1007/s00586-010-1491-x
Magnetic resonance imaging assessment of regional abdominal muscle function in elite AFL players with and without low back pain
Hides, Julie Anne, Hughes, Brita and Stanton, Warren Robert. (2011). Magnetic resonance imaging assessment of regional abdominal muscle function in elite AFL players with and without low back pain. Manual Therapy (online version). 16(3), pp. 279 - 284. https://doi.org/10.1016/j.math.2010.11.009
Psoas and quadratus lumborum muscle asymmetry among elite Australian Football League players
Hides, Julie Anne, Fan, Theresa, Stanton, Warren Robert, Stanton, P, McMahon, Catherine and Wilson, Stephen. (2010). Psoas and quadratus lumborum muscle asymmetry among elite Australian Football League players. British Journal of Sports Medicine. 44(8), pp. 563 - 567. https://doi.org/10.1136/bjsm.2008.048751
Consistency in size and asymmetry of the psoas major muscle among elite footballers
Stewart, Stephen, Stanton, Warren Robert, Wilson, Stephen and Hides, Julie Anne. (2010). Consistency in size and asymmetry of the psoas major muscle among elite footballers. British Journal of Sports Medicine. 44(16), pp. 1173 - 1177. https://doi.org/10.1136/bjsm.2009.058909
Sensory system function and postural stability in men aged 30-80 years
Illing, Sara, Low Choy, Nancy, Nitz, Jennifer and Nolan, Melissa. (2010). Sensory system function and postural stability in men aged 30-80 years. The Aging Male. 13(3), pp. 202 - 210. https://doi.org/10.3109/13685531003657826
Validity of real-time ultrasound imaging to measure anterior hip muscle size: A comparison with magnetic resonance imaging
Mendis, Dilani, Wilson, Stephen, Stanton, Warren and Hides, Julie. (2010). Validity of real-time ultrasound imaging to measure anterior hip muscle size: A comparison with magnetic resonance imaging. Journal of Orthopaedic and Sports Physical Therapy. 40(9), pp. 577 - 581. https://doi.org/10.2519/jospt.2010.3286
A magnetic resonance imaging investigation of the transversus abdominins muscle during drawing-in of the abdominal wall in elite Australian football league players with and without low back pain
Hides, Julie Anne, Boughen, Carly, Stanton, Warren Robert, Strudwick, Mark and Wilson, Steve. (2010). A magnetic resonance imaging investigation of the transversus abdominins muscle during drawing-in of the abdominal wall in elite Australian football league players with and without low back pain. Journal of Orthopaedic and Sports Physical Therapy. 40(1), pp. 4 - 10. https://doi.org/10.2519/jospt.2010.3177
Countermeasures against lumbar spine deconditioning in prolonged bed rest : resistive exercise with and without whole body vibration
Hides, Julie Anne, Belavy, Daniel, Armbrecht, Gabriele, Richardson, Carolyn, Felsenberg, Dieter and Gast, U. (2010). Countermeasures against lumbar spine deconditioning in prolonged bed rest : resistive exercise with and without whole body vibration. Journal of Applied Psychology. 109(6), pp. 1801 - 1811. https://doi.org/10.1152/japplphysiol.00707.2010
Age-related changes in musculoskeletal function, balance and mobility measures in men aged 30-80 years
Nolan, Melissa, Nitz, Jennifer, Low Choy, Nancy and Illing, Sara. (2010). Age-related changes in musculoskeletal function, balance and mobility measures in men aged 30-80 years. The Aging Male. 13(3), pp. 194 - 201. https://doi.org/10.3109/13685531003657818
Retraining motor control of abdominal muscles among elite cricketers with low back pain
Hides, Julie Anne, Stanton, Warren Robert, Wilson, Stephen, Freke, Matt, McMahon, Shaun and Sims, K. (2010). Retraining motor control of abdominal muscles among elite cricketers with low back pain. Scandinavian Journal of Medicine & Science in Sports. 20(6), pp. 834 - 842. https://doi.org/10.1111/j.1600-0838.2009.01019.x
The reliability and validity of the alcohol, smoking and substance involvement screening test (assist)
Hides, L., Cotton, Sue, Berger, G., Gleeson, John, O'Donnell, C., Proffitt, T., McGorry, Patrick and Lubman, Dan. (2009). The reliability and validity of the alcohol, smoking and substance involvement screening test (assist). Addictive Behaviors. 34(10), pp. 821 - 825. https://doi.org/10.1016/j.addbeh.2009.03.040
Different ways to balance the spine: Subtle changes in sagittal spinal curves affect regional muscle activity
Claus, Andrew, Hides, Julie, Moseley, G. Lorimer and Hodges, Paul. (2009). Different ways to balance the spine: Subtle changes in sagittal spinal curves affect regional muscle activity. Spine. 34(6), pp. 208 - 214. https://doi.org/10.1097/BRS.0b013e3181908ead
The association between degenerative hip joint pathology and size of the gluteus maximus and tensor fascia lata muscles
Grimaldi, Alison, Richardson, Carolyn, Durbridge, Gail, Donnelly, William, Darnell, Ross and Hides, Julie Anne. (2009). The association between degenerative hip joint pathology and size of the gluteus maximus and tensor fascia lata muscles. Manual Therapy. 14(6), pp. 611 - 617. https://doi.org/10.1016/j.math.2008.11.002
The effect of chronic low back pain on size and contraction of the lumbar multifidus muscle
Wallwork, Tracy, Stanton, Warren, Freke, Matt and Hides, Julie. (2009). The effect of chronic low back pain on size and contraction of the lumbar multifidus muscle. Manual Therapy. 14(5), pp. 496 - 500. https://doi.org/10.1016/j.math.2008.09.006
Effect of prolonged bed rest on the anterior hip muscles
Mendis, Dilani, Hides, Julie, Wilson, Stephen, Grimaldi, Alison, Belavy, Daniel, Stanton, Warren, Felsenberg, Dieter, Rittweger, Jorn and Richardson, Carolyn A.. (2009). Effect of prolonged bed rest on the anterior hip muscles. Gait & Posture. 30(4), pp. 533 - 537. https://doi.org/10.1016/j.gaitpost.2009.08.002
The association between degenerative hip joint pathology and size of the gluteus medius, gluteus minimus and piriformis muscles
Grimaldi, Alison, Richardson, Carolyn, Stanton, Warren Robert, Durbridge, Gail, Donnelly, William and Hides, Julie Anne. (2009). The association between degenerative hip joint pathology and size of the gluteus medius, gluteus minimus and piriformis muscles. Manual Therapy. 14(6), pp. 605 - 610. https://doi.org/10.1016/j.math.2009.07.004
Altered response of the anterolateral abdominal muscles to stimulated weight-bearing in subjects with low back pain
Hides, Julie, Belavy, Daniel, Cassar, Lana, Willia, Michelle, Wilson, Stephen and Richardson, Carolyn A.. (2009). Altered response of the anterolateral abdominal muscles to stimulated weight-bearing in subjects with low back pain. European Spine Journal. 18(3), pp. 410 - 418. https://doi.org/10.1007/s00586-008-0827-2
Is 'ideal' sitting posture real?: Measurement of spinal curves in four sitting postures
Claus, Andrew, Hides, Julie, Moseley, G. Lorimer and Hodges, Paul. (2009). Is 'ideal' sitting posture real?: Measurement of spinal curves in four sitting postures. Manual Therapy. 14(4), pp. 404 - 408. https://doi.org/10.1016/j.math.2008.06.001
MRI study of the size, symmetry and function of the trunk muscles among elite cricketers with and without low back pain
Hides, Julie, Stanton, Warren, Freke, Matt, Wilson, Stephen, McMahon, Shaun and Richardson, Carolyn A.. (2008). MRI study of the size, symmetry and function of the trunk muscles among elite cricketers with and without low back pain. British Journal of Sports Medicine. 42(10), pp. 809 - 813. https://doi.org/10.1136/bjsm.2007.044024
Sitting versus standing: Does the intradiscal pressure cause disc degeneration or low back pain?
Claus, Andrew, Hides, Julie, Moseley, G. Lorimer and Hodges, Paul. (2008). Sitting versus standing: Does the intradiscal pressure cause disc degeneration or low back pain? Journal of Electromyography and Kinesiology. 18(4), pp. 550 - 558. https://doi.org/10.1016/j.jelekin.2006.10.011
Linking stability to demographics, strength and sensory system function in women over 40 to support pre-emptive preventive intervention
Low Choy, Nancy, Brauer, Sandy and Nitz, Jennifer. (2008). Linking stability to demographics, strength and sensory system function in women over 40 to support pre-emptive preventive intervention. Climacteric. 11(2), pp. 144 - 154. https://doi.org/10.1080/13697130801931821
Resistive simulated weightbearing exercise with whole body vibration reduces lumbar spine deconditioning in bed-res
Belavy, Daniel, Hides, Julie, Wilson, Stephen, Stanton, Warren, Dimeo, Fernando, Rittweger, Jorn, Felsenberg, Dieter and Richardson, Carolyn A.. (2008). Resistive simulated weightbearing exercise with whole body vibration reduces lumbar spine deconditioning in bed-res. Spine. 33(5), pp. 121 - 131. https://doi.org/10.1097/BRS.0b013e3181657f98
Effect of stabilization training on multifidus muscle cross-sectional area among young elite cricketers with low back pain
Hides, Julie, Stanton, Warren, McMahon, Shaun, Si, K. and Richardson, Carolyn A.. (2008). Effect of stabilization training on multifidus muscle cross-sectional area among young elite cricketers with low back pain. Journal of Orthopaedic and Sports Physical Therapy. 38(3), pp. 101 - 108. https://doi.org/10.2519/jospt.2008.2658
Multifidus size and symmetry among chronic IBP and healthy asymptomatic subjects
Hides, Julie, Gilmore, Craig, Stanton, Warren and Bohlscheid, Emma. (2008). Multifidus size and symmetry among chronic IBP and healthy asymptomatic subjects. Manual Therapy. 13(1), pp. 43 - 49. https://doi.org/10.1016/j.math.2006.07.017
Assessment of abdominal muscle function during a simulated unilateral weigh bearing task using ultrasound imaging
Hides, Julie, Wong, Ian, Wilson, Stephen, Belavy, Daniel and Richardson, Carolyn A.. (2007). Assessment of abdominal muscle function during a simulated unilateral weigh bearing task using ultrasound imaging. Journal of Orthopaedic and Sports Physical Therapy. 37(8), pp. 467 - 471. https://doi.org/10.2519/jospt.2007.2417
Ultrasound imaging assessment of abdominal muscle function during drawing-in of the abdominal wall: an intrarater reliability study
Richardson, Carolyn A., Miokovic, Tanja, Belavy, Daniel, Stanton, Warren and Hides, Julie. (2007). Ultrasound imaging assessment of abdominal muscle function during drawing-in of the abdominal wall: an intrarater reliability study. Journal of Orthopaedic and Sports Physical Therapy. 37(8), pp. 480 - 486. https://doi.org/10.2519/jospt.2007.2416
Age-related changes in strength and somatosensation during midlife: rationale for targeted preventive intervention programs
Low Choy, Nancy, Brauer, Sandy and Nitz, Jennifer. (2007). Age-related changes in strength and somatosensation during midlife: rationale for targeted preventive intervention programs. Annals of the New York Academy of Sciences. 1114(1), pp. 180 - 193. https://doi.org/10.1196/annals.1396.014
Rehabilitative ultrasound imaging of the posterior paraspinal muscles
Stokes, Maria, Hides, Julie, Elliott, James, Kiesel, Kyle and Hodges, Paul. (2007). Rehabilitative ultrasound imaging of the posterior paraspinal muscles. Journal of Orthopaedic and Sports Physical Therapy. 37(10), pp. 581 - 595. https://doi.org/10.2519/jospt.2007.2599
The ability to predict dynamic foot posture from static measurements
Franettovich-Smith, M., McPoil, T. G., Russell, T., Skardoon, G and Vicenzino, Bill. (2007). The ability to predict dynamic foot posture from static measurements. Journal of the American Podiatric Medical Association. 97(2), pp. 115 - 120. https://doi.org/10.7547/0970115
Timed stance performances reflect differences in age, prevalence of comorbidities, medication use, fall history and activity level: Early screening for balance loss is indicated
Low Choy, Nancy, Brauer, Sandy and Nitz, Jennifer. (2007). Timed stance performances reflect differences in age, prevalence of comorbidities, medication use, fall history and activity level: Early screening for balance loss is indicated. Australasian Journal on Ageing. 26(1), pp. 29 - 34. https://doi.org/10.1111/j.1741-6612.2007.00202.x
Rehabilitative ultrasound imaging of the abdominal muscles
Teyhen, Deydre, Gill, Norman, Whitake, Jackie, Henry, Sharon, Hides, Julie and Hodges, Paul. (2007). Rehabilitative ultrasound imaging of the abdominal muscles. Journal of Orthopaedic and Sports Physical Therapy. 37(8), pp. 450 - 466. https://doi.org/10.2519/jospt.2007.2558
Magnetic resonance imaging assessment of trunk muscles during prolonged bed rest
Hides, Julie, Belavy, Daniel, Stanton, Warren, Wilson, Stephen, Rittweger, Jorn, Felsenberg, Dieter and Richardson, Carolyn A.. (2007). Magnetic resonance imaging assessment of trunk muscles during prolonged bed rest. Spine. 32(15), pp. 1687 - 1692. https://doi.org/10.1097/BRS.0b013e318074c386
Intrarater and interrater reliability of assessment of lumbar multifidus thickness using rehabilitative ultrasound imaging
Wallwork, Tracy, Hides, Julie and Stanton, Warren. (2007). Intrarater and interrater reliability of assessment of lumbar multifidus thickness using rehabilitative ultrasound imaging. Journal of Orthopaedic and Sports Physical Therapy. 37(10), pp. 608 - 612. https://doi.org/10.2519/jospt.2007.2418
A pilot study of the initial effects of anti-pronation taping on electromyographic activity of lower leg muscles during walking
Franettovich, M., Chapman, A. and Vicenzino, B.. (2006). A pilot study of the initial effects of anti-pronation taping on electromyographic activity of lower leg muscles during walking. Journal of Science and Medicine in Sport. 9(1), pp. 33-34. https://doi.org/10.1016/j.jsams.2006.12.078
An MRI investigation into the function of the transversus abdominis muscle during "drawing-in" of the abdominal wall
Hides, Julie, Wilson, Stephen, Stanton, Warren, McMahon, Shaun, Keto, Heidi, McMahon, Catherine, Bryant, Mary and Richardson, Carolyn A.. (2006). An MRI investigation into the function of the transversus abdominis muscle during "drawing-in" of the abdominal wall. Spine. 31(6), pp. 175 - 178. https://doi.org/10.1097/01.brs.0000202740.86338.df
The use of real-time ultrasound imaging for biofeedback of lumbar multifidus muscle contraction in healthy subjects
Van, Khai, Hides, Julie and Richardson, Carolyn A.. (2006). The use of real-time ultrasound imaging for biofeedback of lumbar multifidus muscle contraction in healthy subjects. Journal of Orthopaedic and Sports Physical Therapy. 36(12), pp. 920 - 925. https://doi.org/10.2519/jospt.2006.2304
Low back pain patients demonstrate increased hip extensor muscle activity during standardized submaximal rotational efforts
Pirouzi, Soraya, Hides, Julie, Richardson, Carolyn A., Darnell, Ross and Toppenberg, Rowena. (2006). Low back pain patients demonstrate increased hip extensor muscle activity during standardized submaximal rotational efforts. Spine. 31(26), pp. 999 - 1005. https://doi.org/10.1097/01.brs.0000250076.74366.9d
Balance, mobility and gaze stability deficits remain following surgical removal of vestibular schwannoma (acoustic neuroma): An observational study
Low Choy, Nancy, Johnson, Natalie, Treleaven, Julia, Jull, Gwendolen, Panizza, Ben and Brown-Rothwell, David. (2006). Balance, mobility and gaze stability deficits remain following surgical removal of vestibular schwannoma (acoustic neuroma): An observational study. Journal of Physiotherapy. 52(3), pp. 211 - 216.
The relationship of cervical joint position error to balance and eye movement disturbances in persistent whiplash
Treleaven, Julia, Jull, Gwendolen and Low Choy, Nancy. (2006). The relationship of cervical joint position error to balance and eye movement disturbances in persistent whiplash. Manual Therapy. 11, pp. 99 - 106.
Initial effects of anti-pronation tape on the medial longitudinal arch during walking and running
Vicenzino, Bill, Franettovich-Smith, M., McPoil, T. G., Russell, T and Skardoon, G. (2005). Initial effects of anti-pronation tape on the medial longitudinal arch during walking and running. British Journal of Sports Medicine. 39(12), pp. 939 - 943. https://doi.org/10.1136/bjsm.2005.019158
MRI measures of the lumbo-pelvic muscles in bedrest and follow-up: Implications for exercise countermeasures in microgravity.
Richardson, Carolyn A., Hides, Julie, Wilson, Stephen, Belavy, Daniel, Stanton, Warren, McCook, D, Elmann-Larsen, B, Rittweger, Jorn and Felsenberg, Dieter. (2005). MRI measures of the lumbo-pelvic muscles in bedrest and follow-up: Implications for exercise countermeasures in microgravity. Journal of Gravitational Physiology. 12(1), pp. 117 - 118.
Smooth Pursuit Neck Torsion test in whiplash-associated disorders: relationship to self-reports of neck pain and disability, dizziness and anxiety
Treleaven, Julia, Jull, Gwendolen and Low Choy, Nancy. (2005). Smooth Pursuit Neck Torsion test in whiplash-associated disorders: relationship to self-reports of neck pain and disability, dizziness and anxiety. Journal of Rehabilitation Medicine. 37, pp. 219 - 223.
Long-term overactivity in the abdominal oblique muscle after 8 weeks bed-rest - possible implications for musculoskeletal health
Belavy, Daniel, Richardson, Carolyn A., Wilson, Stephen, Darnell, Ross, Hides, Julie, Toppenberg, Rowena, Elmann-Larsen, B, Rittweger, Jorn and Felsenberg, Dieter. (2005). Long-term overactivity in the abdominal oblique muscle after 8 weeks bed-rest - possible implications for musculoskeletal health. Journal of Gravitational Physiology. 12(1), pp. 117 - 118.
The effect of depression on balance decline in mature women
Nitz, Jennifer, Low Choy, Nancy and Ogilvie, Meredith. (2005). The effect of depression on balance decline in mature women. Hong Kong Physiotherapy Journal. 23(1), pp. 27 - 35. https://doi.org/10.1016/S1013-7025(09)70056-9
Standing balance in persistent whiplash: a comparison between subjects with and without dizziness
Treleaven, Julia, Jull, Gwendolen and Low Choy, Nancy. (2005). Standing balance in persistent whiplash: a comparison between subjects with and without dizziness. Journal of Rehabilitation Medicine. 37, pp. 224 - 229.