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Abstract
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Howell DR, Seehusen CN, Carry PM, Walker GA, Reinking SE, Wilson JC. An 8-Week Neuromuscular Training Program After Concussion Reduces 1-Year Subsequent Injury Risk: A Randomized Clinical Trial. Am J Sports Med. 2022;50:1120-9.
Among post-concussion children, what is the therapeutic efficacy of neuromuscular training (NMT), compared with standard care, in reducing subsequent injury?
Sports-related, time-loss injuries were more common among standard care relative to NMT intervention, 75% (95% CI, 48%-93%) vs 36% (95% CI, 11%-69%). Adjusted hazard ratio of subsequent injury in the standard care group was 3.56 (95% CI, 1.11-11.49).
Commentary
Howell et al conducted a well-designed RCT assessing whether youth athletes who recently sustained a concussion could reduce the risk of a subsequent sports-related time-loss injury by performing a NMT program consisting of 20 minute, twice-weekly sessions for 8 weeks. Despite a small sample size, the investigators reported a lower incidence of injury after concussion in the NMT group, with the most pronounced effects in the first 90 days post-concussion. While there were some inherent differences between groups, with 1) a 16-day symptom-free waiting period prior to return to play clearance in the standard of care group compared to just 5 days for the NMT group, and 2) a higher proportion of the NMT group were already physically active prior to the initial evaluation, the findings are still significant and clinically relevant. A 20 minute, twice weekly training session is a feasible in-season intervention and does not appear to have much risk for harm. Further investigation as to whether these results can be replicated with the intervention implemented by school athletic trainers or remotely via telehealth is important to understand for health equity. If replicated, this would increase training accessibility and allow athletes who do not have easy access to a specialized clinic to benefit from the training program...
Language: en |