Post-Concussion Neuromuscular Function and Musculoskeletal Injury Risk

• Sponsor
  Henry M. Jackson Foundation, Prime: Uniformed Services University of the Health Services Department of Defense $567,846

• Principal investigator
  Robert Lynall
  Associate Professor, Department of Kinesiology

• Co-principal investigators
  Julianne Schmidt
  Associate Professor, Department of Kinesiology
  Jarrod Call
  Associate Professor, Department of Kinesiology

• Active since
  September 2021

Abstract

Musculoskeletal injuries (MSKI) are the greatest medical problem degrading force readiness. MSKI affect 800,000 service members annually and result in cumulative limited duty days equivalent to 68,000 service members per year who are unable to perform their assigned duties. Another major medical issue, traumatic brain injury (TBI), accounts for one in five combat casualties. TBI has affected more than 350,000 in the past 16 years, and concussion—a mild form of TBI—is known to increase MSKI risk. Specifically, concussed service members have a 49% greater risk of sustaining a MSKI following a concussion than non-concussed service members.

A number of potential neuromuscular control factors have been suggested as possible mechanisms for increased MSKI risk following concussion; however, none have been confirmed with a comprehensive, prospective study. Thus, clinicians are limited in their abilities to design and implement targeted post-concussion intervention strategies to mitigate increased MSKI risk following concussion. We will employ a multi-center prospective, case-matched control observational study to identify the differences in neuromuscular control following concussion that may contribute to increased MSKI risk. Adult concussed service members and physically active civilians who are within five days of full return-to-duty/activity (RTD/A) and sex, age, occupation, and physical activity matched non-concussed controls will participate in this study.

Participants will undergo repeat comprehensive biomechanical, neuromuscular, and sensory assessments to elucidate the underlying mechanisms that may contribute to increased MSKI risk following concussion. MSKI and patient reported outcomes data will be self-reported, monthly, for up to one year following study enrollment. In the near-term, our proposed study can lead to advancements in post-concussion functional assessments and MSKI risk mitigation strategies. However, in the long-term, our findings can transform post-concussion care by highlighting the need to not only address symptoms, neurocognition, and balance deficits following concussion, but also increased MSKI risk.