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Loss of Motor Stability After Sports-Related Concussion: Opportunities for Motor Learning Strategies to Reduce Musculoskeletal Injury Risk
Sports Medicine ( IF 9.3 ) Pub Date : 2021-08-02 , DOI: 10.1007/s40279-021-01527-5
Jason M Avedesian 1, 2 , Harjiv Singh 1 , Jed A Diekfuss 2, 3 , Gregory D Myer 2, 3, 4, 5 , Dustin R Grooms 6, 7, 8
Affiliation  

Current best practices to direct recovery after sports-related concussion (SRC) typically require asymptomatic presentation at both rest and during a graduated exercise progression, and cognitive performance resolution. However, this standard of care results in a significantly elevated risk for musculoskeletal (MSK) injury after return-to-sport (RTS). The elevated risk is likely secondary to, in part, residual neurophysiological and dual-task motor stability deficits that remain despite RTS. These deficits present as a loss of autonomous control of gait and posture and an increased need for cognition for motor stability. Thus, the incorporation of strategies that can enhance motor stability and restore autonomous control of gait and posture during SRC recovery and RTS progression may facilitate a reduction of the elevated risk of secondary MSK injury. We provide a theoretical framework for the application of motor learning principles to restore autonomous gait and postural stability after SRC via incorporation, or targeted manipulation, of external focus, enhanced expectations, autonomy support, practice schedule variability, and dual-task strategies during rehabilitation and RTS training.



中文翻译:

运动相关脑震荡后运动稳定性丧失:减少肌肉骨骼损伤风险的运动学习策略的机会

当前在运动相关脑震荡 (SRC) 后指导恢复的最佳实践通常需要在休息和渐进式运动过程中无症状表现,以及认知表现解决。然而,这种护理标准会显着增加恢复运动 (RTS) 后肌肉骨骼 (MSK) 损伤的风险。风险升高可能部分是继发于尽管 RTS 仍然存在的残余神经生理学和双任务运动稳定性缺陷。这些缺陷表现为步态和姿势的自主控制能力丧失以及对运动稳定性认知的需求增加。因此,在 SRC 恢复和 RTS 进展期间结合可以增强运动稳定性并恢复步态和姿势的自主控制的策略可能有助于降低继发性 MSK 损伤的风险升高。我们提供了一个理论框架,用于应用运动学习原理来恢复 SRC 后的自主步态和姿势稳定性,通过整合或有针对性的操作,外部焦点、增强的期望、自主支持、练习日程可变性和康复期间的双任务策略。 RTS 培训。

更新日期:2021-08-02
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