Changes in Measures of Cervical Spine, Vestibulo-ocular Reflex, Dynamic Balance and Divided Attention Following Sport-Related Concussion in Elite Youth Ice Hockey Players

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SCIENCE
Changes in Measures of Cervical Spine, Vestibulo-ocular Reflex, Dynamic Balance and Divided Attention Following Sport-Related Concussion in Elite Youth Ice Hockey Players
Key Take-Away: 

The study elucidates the issues that affect the players' performance after concussion. Concussion, a traumatic brain injury is counted among the most complex injuries of sports to diagnose and manage. The skill performance of players is affected due to concussion as it leads to neuromotor or cognitive impairments but to what extent is not well known.

Introduction
The concussion is an injury that frequently occurred among the players. But, how the concussion affects the vestibulo-ocular reflex (VOR), divided attention, cervical spine and dynamic balance are not well known. The study was aimed to assess acute changes in measures of the vestibulo-ocular reflex (VOR), divided attention, cervical spine and dynamic balance among elite youth ice hockey players after the sport-related concussion.

 

Methods
The elite ice hockey players of age 13 to 17 years old completed the measures. Measures used for vestibulo-ocular reflex (VOR) were head thrust test, dynamic visual acuity (DVA) (clinical and computerized; for divided attention was Walking While Talking (WWTT) test; for cervical spine were anterolateral strength, joint position error, head perturbation test, cervical flexor endurance test (CFE) and cervical flexion rotation test and for dynamic balance was Functional Gait Assessment (FGA).

 

Results
Out of 97, 69 (71%) players completed at least one test at both preseason and sharply post-concussion (average four days post-concussion). As per Wilcoxon Signed-Rank Test, the cervical spine measures were considerably worse succeeding concussion compared to baseline, head perturbation test and anterolateral neck strength ( p<0.00001, <0.001 and <0.0001, respectively) after bonferroni corrections (α=0.00625). As compared to relative to normal walking speed, the time taken to perform a complex job of divided attention was getting improved relative to preseason (z=-2.59, p=0.0096). No change was noticed in dynamic balance or VOR after the concussion.

 

Conclusions
Divided attention and cervical spine function measures were affected succeeding concussion. No significant change was noticed regarding dynamic balance and VOR associated measures than baseline. More investigation is required to assess the mechanism behind these changes.

Source:

J Orthop Sports Phys Ther

Link to the source:

https://www.ncbi.nlm.nih.gov/pubmed/30053794

Original title of article:

Changes in Measures of Cervical Spine, Vestibulo-ocular Reflex, Dynamic Balance and Divided Attention Following Sport-Related Concussion in Elite Youth Ice Hockey Players.

Authors:

Kathryn J. Schneider et al.

Exploratory, Concussion, Brain, Walking While Talking (WWTT) test, Cervical flexor endurance test (CFE), Cervical flexion rotation test, Functional Gait Assessment (FGA)
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