ACL injuries are one of the most common sports injuries affecting adolescent athletes, leading to lost playing time and high healthcare costs. Research presented today at the American Orthopaedic Society for Sports Medicine’s Annual Meeting in San Diego shows athletes who experience fatigue – tested on a standardized assessment -¬ demonstrated increased risk of ACL injury. The study is the first to measure the direct impact of fatigue on injury risk in the adolescent population.
“We studied 85 athletes at an average age of 15.4 years, and found 44.7% showed an increased injury risk after high-intensity aerobic activity,” noted lead author Mohsin S. Fidai, MD, from Henry Ford Health System in Detroit. “Additionally, 68% of those studied were identified as having a medium- or high-risk for injury following the activity, as compared to 44% at baseline.”
The study utilized vertical and drop-jump assessments of each athlete, which were captured on video and reviewed by 11 professional health observers. Participants included track and field, basketball, volleyball, and soccer athletes. Injury risk was also associated with the level of fatigue, as 14 of 22 athletes demonstrating over 20% fatigue showed an increased ACL injury risk. Female athletes and those over age 15 were also more likely to demonstrate an increased injury risk.
“While ACL injury prevention programs are commonly used now, a decrease in injury numbers has not followed suit,” commented Fidai. “We hope this study helps advocate for ACL injury prevention training programs to incorporate fatigue resistance training and awareness by coaches, trainers and physical education teachers.”
MINNEAPOLIS – A blood test may help researchers understand which people may take years to recover from concussion, according to a study published in the May 27, 2020 online issue of Neurology®, the medical journal of the American Academy of Neurology. The study looked at a biomarker called neurofilament light chain, a nerve protein that can be detected in the blood when nerve cells are injured or die.
Researchers found that, years later, people with a history of three or more concussions were more likely to have high levels of the biomarker than people who had not had a concussion. High levels of the biomarker were also associated with more severe symptoms such as post-traumatic stress disorder and depression years after the concussions occurred.
“While most people with mild concussions recover completely, some never get their lives back fully because of chronic disability,” said study author Kimbra L. Kenney, M.D., of the National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Md., and a Fellow of the American Academy of Neurology. “These people may benefit greatly from a test that could predict those disabilities years ahead of time. Our study found there’s great potential for this protein to predict the problems people with concussions may experience years after their injuries.”
The study involved 195 military veterans with an average age of 38; 85 percent were male. Participants were divided into three groups: 45 people with no history of concussions, 94 people with one or two concussions, and 56 people with three or more concussions. It had been at least seven years since the last concussion for the participants. They were also tested to confirm whether they had symptoms of post-traumatic stress disorder, depression or post-concussive syndrome, which refers to lingering symptoms like mood changes, memory problems and headaches after a concussion.
Blood samples were taken to determine levels of the protein in participants. Then they measured levels of protein in the blood overall as well as in the exosomes found in the blood. Exosomes are like tiny bubbles that carry protein and other information between cells. The average blood levels of neurofilament light were 33% higher in those with three or more concussions than those who had never had a concussion. Exosomal levels were similarly 34% higher in those with multiple concussions. Two other proteins associated with inflammation were also increased in those with multiple concussions.
“The main finding in the study is that people with multiple concussions have more of these proteins in their blood, even years after the last injury,” said Kenney. “Additionally, these proteins may help predict who will experience more severe symptoms such as PTSD and depression. That’s exciting because we may be able to intervene earlier to help lessen the overall effects of concussions over time.”
Kenney said a limitation of the study was the relatively small number of people involved and the need to verify these results in a much larger, separate group of people.
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The study was supported by the Department of Defense, Department of Veterans Affairs and National Institutes of Health.
Learn more about concussion at BrainandLife.org, home of the American Academy of Neurology’s free patient and caregiver magazine focused on the intersection of neurologic disease and brain health. Follow Brain & Life® on Facebook, Twitter and Instagram.
The American Academy of Neurology is the world’s largest association of neurologists and neuroscience professionals, with over 36,000 members. The AAN is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, concussion, Parkinson’s disease and epilepsy.
PULLMAN, Wash. – States with college teams in strong conferences, in particular the Southeastern Conference (SEC), were among the last to take up regulations on youth concussions, according to a recent study. The study, which investigated the association between youth sport participation and passage of concussion legislation, uncovered the importance of SEC affiliation, and found a similar connection in states with high rates of high school football participation.
In contrast, states with higher gender equality, measured by the number of women in the labor force, were early adopters.
Washington State University sociologists Thomas Rotolo and Michael Lengefeld, a recent WSU Ph.D. now at Goucher College, analyzed the wave of youth concussion laws from 2007 to 2014, specifically looking at return-to-play guidelines: a mandated 24-hour wait period before sending a player with a possible concussion back on to the field.
“We explored a lot of different ways of measuring college football presence, and the thing that just kept standing out was SEC membership,” said Rotolo, the lead author on the study published in the journal Social Science & Medicine. “Every college town thinks they have a strong college football presence, but the SEC is a very unique conference.”
Co-author Lengefeld, a former high school football player from Texas, knows first-hand how important the sport is throughout the South, but the data showed a specific correlation between resistance to youth concussion regulations among SEC states in particular.
“This SEC variable was similar to the South effect, but not all southern states have an SEC school–and in SEC states the resistance to concussion laws was a bit stronger,” he said.
Lengefeld added that the SEC also stands out since it has the largest number of viewers and brings in more profits than any other conference.
Scientists have known for more than a century that youth concussions were a serious health issue, but the movement to create concussion health policies for youth sports did not gain any ground until a Washington state middle school player was badly injured. In 2006, Zackery Lystedt was permanently disabled after being sent back onto the field following a concussion. The Seattle Seahawks took up the cause in the state, followed by the NFL which took the issue nationwide.
Even though the NFL advocated for youth concussion policy changes, the states responded differently. Washington state, Oregon and New Mexico were among the first to adopt the new return-to-play guidelines, while states like Georgia and Mississippi were among the last.
“There’s clearly something culturally going on that was different in those states,” said Lengefeld.
The researchers also investigated the role of gender equity in concussion adoption since football is often viewed as hyper-masculine. They used women’s participation in the labor market as a rough indicator of a state’s gender egalitarian views and found a statistically significant difference showing that states with higher levels of women’s labor market participation enacted the concussion legislation more quickly.
Lengefeld said the methodology they used in this study can also be applied to analyze how many other health policies are enacted across different states.
“As we were submitting this research for publication, COVID-19 was just starting, and we noticed all the differences in the way states are behaving,” Lengefeld said. “It’s not new for sociologists to study the diffusion of laws at the state level, but this is another way of doing that that incorporates a set of ideas about culture.”
Being able to exercise without pain or injury: it’s every athlete’s dream as well as the goal of RunEASI, a new spin-off of KU Leuven. RunEASI’s wearable measures the impact experienced by runners and provides scientific feedback that can help them avoid and recover from injuries. The spin-off is supported by the Gemma Frisius Fund and the Freshmen investment fund.
Runners typically use a heart rate monitor, but this device does not offer insight into how the body responds to the impact caused by the feet landing on the ground. And yet, this impact is precisely what determines the risk of injuries. RunEASI – which originated from a collaboration between movement and computer scientists at KU Leuven – has therefore developed a wearable application that does assess these important parameters.
This is achieved using a sensor that is attached to the lower back with a belt and is connected to an app. The sensors measures the impact on the body while running and detects any movement compensations that may occur. The app provides feedback to improve the running pattern. RunEASI is the first application that can perform such an analysis and intervention in a scientifically validated and efficient way. The application will be available on the market as of mid-February 2021.
Stability, symmetry, impact
“We are trying to establish the link between the way in which someone runs, the associated impact loads, and the risk of injuries,” says Professor Benedicte Vanwanseele from the Human Movement Biomechanics unit at KU Leuven. “Three parameters are key to this: stability, symmetry, and impact.”
“Research has shown that trunk instability increases with a runner’s fatigue level. When this is combined with high impact loads, this creates a compensatory pattern that increases the risk of overuse injuries. Symmetry shows whether the impact is equally divided between left and right: after an injury, for instance, a runner may favour one leg without realising it. Last, but not least, the impact parameter shows how the body responds to the shocks that occur when the foot strikes the ground.”
“Our tool intervenes when the data show that the runner has a harmful running pattern,” says computer science professor Jesse Davis. “AI allows us to analyse when the body is exposed to the most severe impacts. This can depend on the surface, the pace, the duration of the training, the runner’s fatigue, and other factors. On the basis of this analysis, coaches and physiotherapists can proactively adjust the runners’ training.”
More insight and better support
“With RunEASI we want to help runners, whether it be professional or recreational ones, to achieve their goals with less risk of injury,” explain co-founders Kurt Schütte (CEO) and Tim Op De Beéck (CTO). “The way our sensor is attached is unique and was developed in cooperation with the orthopaedic experts at Steunzoolpunt. It enables us to measure our new movement metrics very efficiently and accurately. Physiotherapists can use this scientific analysis to better assess when someone is ready to resume training after an injury.”
“We strongly believe in digital tools that improve a person’s quality of life, and this ambition is also reflected in RunEASI,” says Steven Spittaels of the Freshmen investment fund. “It’s an application that, thanks to its scientific feedback, can be of great added value to runners and professional healthcare providers. Athletes obviously want to know how to stay injury free and we want to support RunEASI to help them achieve this.”
“We are extremely grateful for the belief and financial support of the Gemma Frisius Fund and Freshmen Fund,” responds CEO Kurt Schütte. “With their support, we can fulfil our mission and ambition to make the world run better.”
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More information
The RunEASI wearable can be pre-ordered and will be available as of mid-February 2021. Check the website for further information: runeasi.ai
