Trunk and lower extremity biomechanics differ between female athletes with and without a concussion history

J Athl Train. 2023 Sep 8. doi: 10.4085/1062-6050-0259.23. Online ahead of print.

Abstract

Context: Athletes with a history of concussion are at a greater risk for lower extremity musculoskeletal injury. Female athletes may be at an even greater risk. Previous landing biomechanics research post-concussion has focused on the lower extremities, but the trunk plays a crucial role as an injury risk factor.

Objective: To compare lower extremity and trunk biomechanics during jump landing and cutting maneuvers between female athletes with and without a concussion history.

Design: Cross-sectional.

Setting: Biomechanics laboratory.

Participants: Our study included 26 athletes with (age:19.0±1.3years, BMI:22.6±2.0kg/m2, time since most recent concussion: median=37.5 months [interquartile range (25.0, 65.8)]), and 38 athletes without (age:19.0±1.1years, BMI:22.1±1.8kg/m2) a concussion history.

Main outcome measures: Peak kinetics (vertical ground reaction force, vertical loading rate, external knee abduction moment, external knee flexion moment) and kinematics (trunk flexion angle, trunk lateral bending angle, dorsiflexion angle, knee flexion angle, knee abduction angle, hip flexion angle) were obtained during the eccentric portion of the task. Separate 2 (group) × 2 (limb) between-within analyses of covariance compared outcomes between groups. We covaried for time since most recent concussion and limb which had a history of musculoskeletal injury.

Results: Athletes with a concussion history displayed a greater nondominant knee abduction angle compared to their dominant limb (p=0.010, np2=0.107) and athletes without a concussion history nondominant limb (p=0.023, np2=0.083) during the jump landing. Athletes with a concussion history displayed less trunk lateral bending during cutting compared with athletes without a concussion history (p=0.005, np2=0.126).

Conclusions: Our results indicate landing biomechanics are different between female athletes with and without a concussion history. This may be due to impairments in neuromuscular control post-concussion which may ultimately increase the risk of subsequent lower extremity injury, although further research is warranted given the cross-sectional nature of our study.

Keywords: cut; drop landing; jump landing; mild traumatic brain injury; sports medicine.