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Sports and Recreational Injury Research ProjectsProspective Investigation of Sport-Related Concussion: Relationship between Biomechanical, Neuroanatomical, and Clinical Factors Objective, non-invasive, and rapid assessment of the severity of head injury is needed to determine when an individual athlete may return to play following injury. The study is designed to evaluate the relationship between biomechanical, neuroanatomical, and clinical factors associated with sport-related concussion. Symptomatology, neuropsychological function, and postural stability measured at selected post-injury points will be correlated to neuroanatomical measures taken with susceptibility weighted imaging and diffusion tensor imaging, as well as to linear and rotational acceleration of the head at impact, as measured by the Head Impact Telemetry System (HITS). The Fall 2008 season marked the start of the fifth year of data collection. To date, in excess of data on 180,000 head impacts have been collected, registering a total of 17 cases of concussion. The initial four years of the study resulted in three companion papers being published in the December 2007 issue of Neurosurgery, and the project was featured in a nationwide NBC news story and on MSNBC.com. Project Period: Key Personnel: Other Organizations or Institutions Represented: Funding: Contact:
Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center The mission of the “Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center” is to improve the prevention, evaluation, management, and rehabilitation of sports-related traumatic brain injuries through research, education, and clinical practice. The Center is under the sponsorship of the University of North Carolina at Chapel Hill's Department of Exercise and Sport Science, in collaboration with several other units, including the UNC Injury Prevention Research Center, UNC School of Medicine, UNC Gillings School of Global Public Health, and UNC Division of Sports Medicine. The Center’s research team also collaborates with concussion experts world-wide to carry out its mission. Through our clinical and research initiatives, the Center’s faculty and staff demonstrate a commitment to providing the highest level of care for athletes of all ages suffering from sports-related brain injuries, and to assist parents, coaches, and medical professionals in managing these student-athletes. The Center carries out its mission through a values-based clinical and research agenda. The program guides clinicians to better manage sports-related concussions and traumatic brain injury and apply the values of:
The Matthew Alan Gfeller Sport-Related Traumatic Brain Injury Research Center is housed in a newly renovated 1,300 sq. ft. space on the top floor of the Stallings-Evans Sports Medicine Center in the heart of UNC-Chapel Hill’s campus. It is a center of excellence for treating athletes suffering from sport-related concussion. This dedicated clinical research space offers state-of-the-art balance assessment, neuropsychological assessment, and other neurological evaluations. The close proximity to the main floor of the UNC Athletic Training Room in Stallings-Evans is ideal for treating collegiate athletes, as well as recreational and high school athletes from the surrounding communities. The Center also serves as an evaluation and treatment facility for UNC’s well-known Center for the Study of Retired Athletes, aimed at investigating a spectrum of physical and mental challenges facing former NFL players. UNC is well recognized nationally and internationally as a research leader focusing on the prevention and management of these often debilitating and potentially catastrophic brain injuries. Our work over the past 16 years has been conducted out of the Sports Medicine Research Laboratory and we have used this time to form a qualified and highly respected interdisciplinary research team, consisting of neuroscientists, physicians, certified athletic trainers, and injury epidemiologists. The newly named Center, allows for Carolina to continue its tradition of excellence in an environment that promotes collaboration between clinicians and researchers with a more clear vision and identity. Ultimately, the major benefactors are the young athletes participating in sports who are at risk for these injuries. For more information, please visit : http://tbicenter.unc.edu/MAG_Center/Home.html Key Personnel: Contact:
JUMP-ACL (Epidemiology of Jump-Landing Movements and ACL Injury) Anterior Cruciate Ligament (ACL) injuries are devastating knee injuries that typically occur in physically active populations. Women have a higher risk of ACL injury than men, but the actual mechanism of this injury is unknown. This study focuses on human movement as a risk factor for ACL injury and combines an epidemiologic prospective cohort design with a biomechanical motion analysis assessment. The subjects in the cohort are female and male cadets and midshipmen at the U.S. Naval Academy, the U.S. Air Force Academy, and the U.S. Military Academy at West Point. Cohort enrollment has been completed, and a total of 5,868 subjects have been enrolled in the cohort (39% are female) and undergone a baseline human movement biomechanical assessment protocol involving a jump-landing task. Motion analysis was completed with electromagnetic system (Flock of Birds). Data collection for ACL injuries is on-going, and, to date the study has registered 68 injuries. Based on preliminary multivariate Poisson regression models, the rate of ACL injury is 2-3 times higher in those subjects with increased knee valgus angle, a greater hip internal rotation angular velocity, and increased vertical ground reaction forces. Subjects who subsequently suffered ACL injury use knee and hip rotation to absorb ground reaction forces. Subjects who did not suffer ACL injury tended to use knee and hip flexion/extension to counteract these same forces. In other words, injured subjects demonstrate a rotation-dominant landing strategy, rather than the usual flexion-dominant strategy. Several conference presentations have been made and three manuscripts have been published. Project Period: Key Personnel: Other Organizations or Institutions Represented: Funding: Contact:
Influence of hamstring muscle stiffness on knee joint stability Anterior cruciate ligament (ACL) injury affects a substantial number of individuals in the U.S. each year, and females demonstrate a substantially greater injury rate than males. Current public health initiatives such as Healthy People 2010 promote healthy lifestyles through physical activity. However, population increases in physical activity will likely result in an increase in the rate of musculoskeletal injuries, including those of the ACL. This investigation will evaluate the influence of hamstring stiffness on knee joint stability in 50 males and 50 females. Knee joint stability will be defined as the amount of anterior tibial translation resulting from a standardized knee joint perturbation. We hypothesize that greater hamstring stiffness will be associated with heightened joint stability (i.e. lesser anterior tibial translation). Our previous work indicates that hamstring stiffness is greater in males than in females. The proposed investigation will evaluate the implications of this sex difference in hamstring stiffness for knee joint stability. We hypothesize that the lesser hamstring stiffness observed in females will translate into diminished knee joint stability (i.e. greater anterior tibial translation). As muscle stiffness can be altered via training and rehabilitation techniques, future prospective injury prevention efforts could be initiated based on the results of this investigation. Project Period: Key Personnel: Other Organizations or Institutions Represented: Funding: Contact:
Validity & Reliability of the NCAA Web-Based Injury Surveillance System The National Collegiate Athletic Association (NCAA) Web-based Injury Surveillance System (ISS) involves hundreds of certified athletic trainers (ATC) in the USA entering injury surveillance data into a web-based system. These data are used by NCAA committees to make decisions relevant to student-athlete welfare and are used by sports medicine researchers around the world. The system is widely regarded as the premier sports injury surveillance system in the world. However, the validity and reliability of these data are currently unknown. This study quantitatively established the reliability and validity of the system. Abstractors visited a sample of 15 schools contributing data to the system and abstracted data on sports-related injuries from sources other than the ISS (hard copy files or other databases). Results indicate that the ISS captures the vast majority of sports injuries (close to 90%) and reliability of most data fields is high (over 90%). A paper reporting the results has been submitted. Project Period: Key Personnel: Other Organizations or Institutions Represented: Funding: Contact:
Center for the Study of Retired Athletes Hundreds of athletes retire every year, many of whom were forced to abuse their bodies throughout a career that likely caused them to play injured and crippled on occasion. These very same ˇ°bodiesˇ± which provided an opportunity of a lifetime for some players, are now deteriorating. The Center for the Study of Retired Athletes, which is housed in the Department of Exercise and Sport Science at UNC-Chapel Hill, was developed in 2000. The primary goals of the Center are to: 1) collect epidemiological data on retired professional athletes; and 2) provide medical care for select retirees in a research setting. The hope is that the research findings will help improve the quality of life for many retired athletes. This information also will be used to prepare active athletes for a healthier retirement. The Center is now focusing on part two of its mission; to provide medical care to select retired NFL players in a research setting. A research project was completed in 2008 in which Retired NFL players with chronic low back pain were invited to the Center for an intensive physical therapy evaluation that includes: 1) a prescription for therapeutic exercises; 2) a consultation with an orthopedic surgeon; 3) a nutrition consultation; and 4) a screening for depression. The results of this study are yet to be published. Currently, the Center is conducting two studies: one explores the relationship between recurrent concussion and hypopituitarism in 90 retired NFL players, and one explores the effects of Omega-3 fatty acid supplementation in 40 retired NFL players who suffer from memory dysfunction. UNC IPRC assists the Center for the Study of Retired Athletes by providing biostatistical support and participating on the Center's advisory board. Project Period: Key Personnel: Other Organizations or Institutions Represented: Funding: Contact:
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