RecruitingNCT05122728

Post-Concussion Musculoskeletal Injury Risks

Post-Concussion Neuromuscular Function and Musculoskeletal Injury Risk

Sponsor

Walter Reed National Military Medical Center

Enrollment

148 participants

Start Date

Oct 20, 2022

Study Type

OBSERVATIONAL

Conditions

Musculoskeletal injury

Summary

Musculoskeletal injuries (MSKI) and traumatic brain injury (TBI) are the signature injuries of the ongoing military conflicts. MSKI affect 800,000 Service Members annually and TBI have impacted more than 350,000 in the past 19 years and account for 22% of all combat casualties. Concussion, a mild form of TBI, increases MSKI risk in physically active individuals, including Service Members. The overall goal of the study is to identify the neuromuscular control mechanisms that increase MSKI risk following concussion. It is hypothesized that concussed individuals will display abnormal neuromuscular function that increases MSKI risk, as compared to non-concussed controls. The study will employ a multi-center, prospective, case-matched control observational study to identify the differences in neuromuscular function following concussion that may contribute to increased MSKI risk. Once the neuromuscular control mechanisms that increase MSKI risk following concussion are identified, targeted risk mitigation strategies can be developed to reduce MSKI risk.

Eligibility

Min Age: 18 YearsMax Age: 40 Years

Inclusion Criteria14

Concussed Cohort
-40 years old.
Self-reported asymptomatic post-concussion following enrollment into the study and monitoring of symptoms by research personnel via daily self-reported symptom questionnaires.
Recruited within 5 days following being diagnosed with a concussion, and at least 72 hours prior to self-reporting as asymptomatic.
Access to a functional email address and the internet for completion of patient reported outcomes (PROs) and musculoskeletal injury measures.
Non-Concussed Cohort
-40 years old.
Active duty Service members and physically active civilians.
No self-report history of concussion within the previous 5 years.
No lingering post-concussion signs/symptoms.
Same gender as the matched concussed participant.
Within ±5% of the matched concussed participant's height, weight, and body mass index.
Within ±2 years of age of the matched concussed participant.
Participant in the same physical activities (work, recreational sports, average type \[no impact, low-impact, high-impact\] and duration of physical activity)

Exclusion Criteria15

Post-Concussion Cohort AND Healthy Non-Concussed Cohort
Unable to read or comprehend the English language.
Admitted to the hospital following concussion.
Sustained a concussion not related to physical activity participation (e.g., blast-related injury, fall from a ladder, motor vehicle accident).
Loss of consciousness longer than 30 minutes.
Alteration in consciousness longer than 24 hours.
Post-traumatic amnesia lasting longer than 1 day.
Glasgow Coma Scale below 13.
Abnormal brain imaging findings.
Sustained a concussion that took longer than 21 days for the individual to report as asymptomatic.
A MSKI within the last 6 months that resulted in altered or missed physical activity for 3 or more consecutive days.
History of MSKI surgery.
Pregnant females (will be eligible for participation in the study once medically cleared to RTD/A by a qualified and licensed healthcare provider following the end of the pregnancy).
Participants will be excluded if they present any known contraindications for electrical stimulation. These contraindications include conditions such as: active deep vein thrombosis/thrombophlebitis, any acute injury with concurrent inflammation, hemorrhagic conditions, impaired circulation, impaired local sensations, presence of infection (osteomyelitis, tuberculosis), malignancy, recently radiated tissue, skin disease/damage and/or at-risk skin.
Present with any implanted pacemaker, electronic device, or plastic/cement material

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Interventions

OTHERPost-Concussion Neuromuscular Function and Musculoskeletal Injury Risk Assessment

Participants will complete a comprehensive biomechanical and neuromuscular assessments to elucidate the underlying neuromuscular control mechanisms that may contribute to increased MSKI risk following concussion. Participants will also complete a battery of self-report psychosocial measures. Biomechanical Dynamic Movement Assessments: * Jump-Landing * Single Leg Hop * Anticipated Cut * Gait - Single Task * Gait - Dual Task Strength and Voluntary Muscle Activation Assessments: * Interpolated Twitch Technique * Muscular Ramp Contraction Sensory assessments: * Proprioception - Closed Chain * Passive Joint Repositioning * Light Touch Sensation Patient Reported Outcomes: * Self-Reported Musculoskeletal Injuries * National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function * PROMIS Pain Interference * PROMIS Depression * PROMIS Anxiety * Brief Resilience Scale (BRS) * Tampa Scale of Kinesiophobia (TSK-11)