@article{ref1,
title="Association between muscle damage and head impacts in high school American football",
journal="International journal of sports medicine",
year="2019",
author="Huibregtse, Megan E. and Zonner, Steven W. and Ejima, Keisuke and Bevilacqua, Zachary W. and Newman, Sharlene D. and Macy, Jonathan T. and Kawata, Keisuke",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="Subconcussive head impacts (SHI), defined as impacts to the cranium that do not result in concussion symptoms, are gaining traction as a major public health concern. The contribution of physiological factors such as physical exertion and muscle damage to SHI-dependent changes in neurological measures remains unknown. A prospective longitudinal study examined the association between physiological factors and SHI kinematics in 15 high school American football players over one season. Players wore a sensor-installed mouthguard for all practices and games, recording frequency and magnitude of all head impacts. Serum samples were collected at 12 time points (pre-season, pre- and post-game for five in-season games, and post-season) and were assessed for an isoenzyme of creatine kinase (CK-MM) primarily found in skeletal muscle. Physical exertion was estimated in the form of excess post-exercise oxygen consumption (EPOC) from heart rate data captured during the five games. Mixed-effect regression models indicated that head impact kinematics were significantly and positively associated with change in CK-MM but not EPOC. There was a significant and positive association between CK-MM and EPOC. These data suggest that when examining SHI, effects of skeletal muscle damage should be considered when using outcome measures that may have an interaction with muscle damage.<br><br>© Georg Thieme Verlag KG Stuttgart · New York.<p /> <p>Language: en</p>",
language="en",
issn="0172-4622",
doi="10.1055/a-1021-1735",
url="http://dx.doi.org/10.1055/a-1021-1735"
}