Athletes who undergo an 8-week neuromuscular training after a concussion have less of a risk of subsequent injury, according to a randomized clinical trial.
“An 8-Week Neuromuscular Training Program After Concussion Reduces 1-Year Subsequent Injury Risk: A Randomized Clinical Trial,” was published online on January 21, 2022 in The American Journal of Sports Medicine.
“Existing data suggest that after concussion, athletes experience an increased risk of subsequent injury. Exploring methods that may reduce injury risk after successful post-concussion return to play may lead to new treatment approaches,” the study authors wrote.
They sought to understand the efficacy of a neuromuscular training intervention on acute-sports-related time-loss injury over the subsequent year compared with standard of care.
Twenty-seven youth athletes were included in the study. They were assessed first on average 7 days after a concussion and then after return-to-play clearance (median, 40 days post-concussion; IQR, 15-52).
After return-to-play clearance, they were randomly assigned to either neuromuscular training (n = 11; mean ±SD age, 14.7 ± 1.7 years; 36% female) or standard of care (n = 16; mean ± SD age, 15.3 ± 1.8 years; 44% female).
Athletes assigned the intervention performed it twice a week for 8 weeks. It included guided strength exercises with landing stabilization focus. All of the athletes were asked to complete a monthly log of sports-related injuries and organized sports competition.
The researchers found that overall sports-related time-loss injuries in the year following a concussion were greater in the standard of care group than the intervention group (75% [95% CI, 48%-93%] vs 36% [95% CI, 11%-69%]).
After adjusting for age and sex, the hazard of subsequent injury in the standard-of-care group was 3.56 times (95% CI, 1.11-11.49; p =.0334) that of the neuromuscular training intervention group.
In addition, sports participation was similar between neuromuscular training intervention and standard of care during the year-long monitoring period (hours of organized sports per month; median, 12 [IQR, 2.6-32.1] vs. 15.6 [IQR, 3.5-105.9]; p = .55). The age- and sex-adjusted incidence of injuries was 10.2 per 1000 competitive exposures 995% CI, 3.7-28.4) in the standard-of-care group as opposed to 3.4 per 1000 (95% CI, 0.9-13.4) in the neuromuscular training intervention group.
After adjusting for age and sex, incidence of injuries was higher for standard of care vs. neuromuscular training intervention (rate ratio, 2.96 [95% CI, 0.89-9.85]; p = .076.
“Although preliminary, our findings suggest that a neuromuscular training intervention initiated after return-to-play clearance may significantly reduce sports-related time-loss injuries over the subsequent year,” the researchers wrote.
The study authors included David R. Howell, Ph.D., A.T.C. of Children’s Hospital of Colorado, Corrine N. Seehusen of Children’s Hospital of Colorado, Patrick M. Carry, Ph.D. of University of Colorado School of Medicine, Gregory A. Walker, M.D., of Children’s Hospital of Colorado and University of Colorado School of Medicine, Sarah E. Reinking, D.P.T., P.T. of Children’s Hospital of Colorado and Julie C Wilson, M.D., of Children’s Hospital of Colorado and University of Colorado School of Medicine.
