Neuromuscular training after concussion to improve motor and psychosocial outcomes: A feasibility trial

Abstract

Objective: To determine the feasibility of an 8-week neuromuscular training program initiated upon return-to-play clearance following concussion.

Design: Feasibility trial.

Setting: A single sports medicine center.

Participants: We approached n = 54 patients; n = 32 agreed to participate (59%). N = 27 participants returned for their second visit at return-to-play clearance (84%) and were randomized to neuromuscular training (n = 13) or standard-of-care (n = 14).

Main outcome measures: Participants completed three assessments: within 14 days post-concussion, immediately after return-to-play clearance, and 8-weeks following return-to-play clearance. The intervention aimed to achieve positive neuromuscular adaptations and occurred 2x/week for 8 weeks under supervision.

Results: N = 2 participants randomized to the intervention elected not to participate, both due to schedule conflicts (e.g., time required to meet with the study team). Participants began the intervention an average of 11 days after return-to-play clearance, the majority (91%) completed >75% of training sessions, and training sessions lasted an average of 18.2 ± 4.8 min. One participant stopped the intervention after 7 training sessions due to time availability.

Conclusion: It is feasible to initiate a neuromuscular training program for most athletes shortly after returning to play following concussion. Clinicians and researchers may consider this approach to mitigate the increased musculoskeletal injury risk for concussion patients returning to sports.

Keywords: Dual-task; Gait; Injury prevention; Mild traumatic brain injury; Quality of life; Symptoms.

Conflict of interest statement

Declaration of competing interest This study was funded by the Children's Hospital Colorado Research Institute Pilot Award Program. Separate from this study, Dr. Howell has received research support from the Eunice Kennedy Shriver National Institute of Child Health & Human Development (R03HD094560), the National Institute of Neurological Disorders And Stroke (R01NS100952, R03HD094560, and R43NS108823), and MINDSOURCE Brain Injury Network. The remaining authors have no conflicts to disclose. We would like to thank Jillian Descoteaux, PhD, ATC, and Scott Long, MS, ATC for their assistance in performing the intervention training.

Copyright © 2021 Elsevier Ltd. All rights reserved.

Figures

Figure 1.

Study flow diagram of the feasibility trial.

Figure 2.

CONSORT (Consolidated Standards of Reporting Trials) diagram.