Sport-related concussion occurs when linear and angular head motion caused by external physical forces disrupts an athlete's brain function at the neuronal level. Athletes with smaller, weaker necks, including child and female athletes, are thought to be at increased risk of concussion because their necks are less able to counter these externally acting forces resulting in more violent head movement patterns. The bi-directional whiplash motion that occurs when an athlete's head rapidly changes its direction of rotation may also increase the risk of concussion associated with an individual impact, as compared to a uni-directional rotation pattern of similar magnitude. The proposed biomechanical investigation will pursue the following specific aims:
AIM 1) to determine the relationship between sonographic measures of cervical muscle size and stiffness and the head's kinematic response under a standardized impulsive force in each anatomical plane across the spectra of age and gender;
AIM 2) to determine whether in vivo commercial impact sensing systems can predict bi-directional versus uni-directional rotation patterns, as determined by a high speed kinematic motion capture system, during a sport-simulated bracing task. The working hypotheses associated with these aims are: H1) the magnitudes of the head's linear and angular velocity changes will be negatively associated with cervical muscle size and stiffness and will be more strongly correlated with these sonographic measures than concurrently measured neck strength in each plane (AIM 1);H2) resultant impact vectors generated by commercial impact sensing systems that are located inferior of the head's center of mass will be associated with bi-directional head rotation patterns, while impact vector locations superior to the head's center of mass will be associated with uni-directional rotation (AIM 2). The Candidate has a clinical background in Physical Medicine and Rehabilitation with expertise in mild traumatic brain injury, specifically sport-related concussion. He has master's level training in clinical research design and statistical analysis as well as additional basic training and experience in biomechanical engineering principles and laboratory techniques. He is committed to a career in sport concussion research focusing on injury biomechanics and he plans to use the additional training he receives through this NIH Career Development Award to support his future work in this field. The Candidate and his mentoring team have designed a career development plan to accomplish three training goals: 1) become proficient in biomechanical modeling techniques to permit effective use and interpretation of basic biomechanical models of the human head and neck, 2) obtain expertise in musculoskeletal ultrasonography, allowing for proficient measurement of cervical muscle size (cross sectional area) and stiffness (elastography), 3) improve grantsmanship skills to facilitate ongoing research support.

Public Health Relevance

Sport-related concussion is a common injury associated with significant short and long term disability. Using healthy young athletes, this project will systematically investigate how neck muscle size and stiffness modulate the kinematic response of the head to impulsive forces of different location and direction (AIM 1) and determine whether commercial in vivo impact sensing systems can identify complex head rotation patterns (AIM 2). The long term goal of this project is to develop strategies to decrease the risk of concussion in athletes.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
1K23HD078502-01A1
Application #
8767355
Study Section
Pediatrics Subcommittee (CHHD)
Program Officer
Michel, Mary E
Project Start
2014-08-15
Project End
2017-07-31
Budget Start
2014-08-15
Budget End
2015-07-31
Support Year
1
Fiscal Year
2014
Total Cost
$132,083
Indirect Cost
$9,583
Name
University of Michigan Ann Arbor
Department
Physical Medicine & Rehab
Type
Schools of Medicine
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Veliz, Philip; Eckner, James T; Zdroik, Jennifer et al. (2018) Lifetime Prevalence of Self-Reported Concussion Among Adolescents Involved in Competitive Sports: A National U.S. Study. J Adolesc Health :
Broglio, Steven P; Williams, Richelle; Rettmann, Ashley et al. (2018) No Seasonal Changes in Cognitive Functioning Among High School Football Athletes: Implementation of a Novel Electrophysiological Measure and Standard Clinical Measures. Clin J Sport Med 28:130-138
Eckner, James T; Goshtasbi, Alireza; Curtis, Kayla et al. (2018) Feasibility and Effect of Cervical Resistance Training on Head Kinematics in Youth Athletes: A Pilot Study. Am J Phys Med Rehabil 97:292-297
Veliz, Phil; McCabe, Sean E; Eckner, James T et al. (2017) Prevalence of Concussion Among US Adolescents and Correlated Factors. JAMA 318:1180-1182
Richardson, James K; Eckner, James T; Allet, Lara et al. (2017) Complex and Simple Clinical Reaction Times Are Associated with Gait, Balance, and Major Fall Injury in Older Subjects with Diabetic Peripheral Neuropathy. Am J Phys Med Rehabil 96:8-16
Martini, Douglas N; Eckner, James T; Meehan, Sean K et al. (2017) Long-term Effects of Adolescent Sport Concussion Across the Age Spectrum. Am J Sports Med 45:1420-1428
Eckner, James T; Seifert, Tad; Pescovitz, Allison et al. (2017) Is Migraine Headache Associated With Concussion in Athletes? A Case-Control Study. Clin J Sport Med 27:266-270
Broglio, Steven P; Williams, Richelle; Lapointe, Andrew et al. (2017) Brain Network Activation Technology Does Not Assist with Concussion Diagnosis and Return to Play in Football Athletes. Front Neurol 8:252
Eckner, James T; Goshtasbi, Alireza; Curtis, Kayla et al. (2016) Poster 195 A Pilot Study of Resistance Exercise Targeting the Neck in Youth Athletes. PM R 8:S224-S225
Eckner, James T; Rettmann, Ashley; Narisetty, Naveen et al. (2016) Stability of an ERP-based measure of brain network activation (BNA) in athletes: A new electrophysiological assessment tool for concussion. Brain Inj 30:1075-81

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