A Sports Injury Prevention Program to Reduce Subsequent Injuries After Concussion
Condition: Brain Concussion; Musculoskeletal Injury; Locomotion; Postural Balance
MeSH terms: Brain Concussion; Wounds and Injuries; Athletic Injuries; Reinjuries
Study type: Interventional

Summary: 
      The long-term goal of this research is to implement methods that healthcare providers can use
      across diverse clinical settings to (1) identify athletes at risk for (musculoskeletal) MSK
      injury when cleared to return to play (RTP) after a concussion and (2) develop practical ways
      to reduce MSK injury risk following concussion RTP. The rationale is that once
      post-concussion MSK injury risk factors are known and prevention strategies tested,
      concussion RTP protocols will evolve to include injury risk reduction programs.
    

Detailed description: 
      Aims:

      i. To determine the effect of a sports injury prevention program on MSK injuries initiated at
      concussion RTP and continued throughout the subsequent athletic season.

      ii. To examine the effect of a neuromuscular training (NMT) program on clinical and
      instrumented postural control measures before and after the intervention.

      The proposed study will use an intervention-based paradigm to further understand MSK injury
      risk after concussion RTP and to identify potential methods to reduce this risk. Common Data
      Element (CDE) and instrumented postural control data will be linked to objectively classify
      the clinical and functional underpinnings of concussion recovery and subsequent MSK injury
      among those engaged in an injury prevention program compared to those who are not. These are
      important elements to investigate because: 1) few studies have explored the mechanisms for
      MSK injury incidence after concussion using a multimodal and objective approach and 2) no
      investigations have examined interventions to improve long-term concussion outcomes initiated
      at RTP.
    

Intervention name(s): Neuromuscular training
Intervention type(s): Behavioral
Intervention description(s): Training will be conducted with a research assistant under the supervision of Dr. Howell (PI), a certified athletic trainer, who will meet with participants either at the individual or small group level (3-4 participants maximum). Training will be done within the Children's Hospital Colorado network-of-care locations, dependent on the location of participants. Due to in-person restrictions that have resulted from COVID-19, participants may also complete the intervention via remote (virtual) training sessions.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Upon clearance to Return to Play (RTP) after concussion, all participants will be randomized to either a Neuromuscular training (NMT) group or usual care (no sports injury prevention training). Those in the NMT group will complete training for 20-30 minutes, two times per week, beginning at RTP and continuing at this frequency until the end of the current athletic season.
Masking: None (Open Label)
Primary purpose: Treatment