Abstract
Sport-related concussion (SRC) is now classified as a major public health concern affecting millions of athletes each year. Recent evidence suggests that previously concussed athletes are at greater risk for lower extremity (LE) injury beyond the resolution of traditional SRC assessment batteries. The current literature has yet to elucidate the biomechanical movement patterns of sport-specific activities that may provide rationale for LE injury risk following SRC. PURPOSE: To examine landing biomechanics in adolescent athletes who report a SRC history. METHODS: Three athletes with a SRC history (age: 11.3 ± 3.5 yrs; previous SRCs: 1.3 ± 0.6) and two athletes without a SRC history (age: 13.0 ± 4.2 yrs) completed drop-landings from 30 cm and 60 cm. Three dimensional kinematic data were measured via a 10-camera motion analysis system at 100 Hz, while kinetic data were collected at 1000 Hz with two adjacent force platforms. The preferred limb to initiate the drop-landing was used for data analysis in comparing landing mechanics between groups. Five landing trials were collected to ensure landing performance stability. The independent variables were group (concussion, control) and landing height (30, 60 cm), while the dependent variables included maximum vertical ground reaction force (vGRF), loading rate, and knee joint kinematic parameters during the landing tasks. RESULTS: Athletes with a previous SRC demonstrated a 7.9% increase (4.22 BWs vs 3.89 BWs) in maximum vGRF and 14.7% increase in loading rate (109.2 BWs / sec vs 93.2 BWs / sec) from the 60 cm height compared to control athletes. Additionally, previously concussed athletes demonstrated an 8.8 degrees (-4.9° vs 3.9°) and 11.2 degrees (-8.1° vs 3.1°) increase in knee abduction angle from the 30 cm and 60 cm heights compared to control athletes. Knee sagittal plane range of motion was decreased by 56.2% (52.0° vs 81.2°) from the 30 cm height and 30.3% (62.3° vs 81.1°) from the 60 cm height in athletes with a previous SRC. CONCLUSIONS: Preliminary analysis highlights that previously concussed adolescent athletes demonstrate landing mechanics that may increase LE injury risk. Specifically, athletes with a SRC history demonstrate sagittal and frontal plane knee motion during landings that are associated with greater risk of an anterior cruciate ligament injury.
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