Does prior concussion lead to biomechanical alterations associated with lateral ankle sprain and anterior cruciate ligament injury? A systematic review and meta-analysis.

Autor:	Chou TY; Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware, USA., Huang YL; Department of Physical Education and Sport, National Taiwan Normal University, Taipei, Taiwan huanyulu@ntnu.edu.tw., Leung W; Department of Health Sciences and Human Performance, The University of Tampa, Tampa, Florida, USA., Brown CN; College of Health, Corvallis, Oregon State University, Corvallis, Oregon, USA., Kaminski TW; Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware, USA., Norcross MF; College of Health, Corvallis, Oregon State University, Corvallis, Oregon, USA.
Jazyk:	angličtina
Zdroj:	British journal of sports medicine [Br J Sports Med] 2023 Dec; Vol. 57 (23), pp. 1509-1515. Date of Electronic Publication: 2023 Aug 30.
DOI:	10.1136/bjsports-2023-106980
Abstrakt:	Objective: To determine whether individuals with a prior concussion exhibit biomechanical alterations in balance, gait and jump-landing tasks with and without cognitive demands that are associated with risk of lateral ankle sprain (LAS) and anterior cruciate ligament (ACL) injury. Design: Systematic review and meta-analysis. Data Sources: Five electronic databases (Web of Science, Scopus, PubMed, SPORTDiscus and CiNAHL) were searched in April 2023. Eligibility Criteria: Included studies involved (1) concussed participants, (2) outcome measures of spatiotemporal, kinematic or kinetic data and (3) a comparison or the data necessary to compare biomechanical variables between individuals with and without concussion history or before and after a concussion. Results: Twenty-seven studies were included involving 1544 participants (concussion group (n=757); non-concussion group (n=787)). Individuals with a recent concussion history (within 2 months) had decreased postural stability (g=0.34, 95% CI 0.20 to 0.49, p<0.001) and slower locomotion-related performance (g=0.26, 95% CI 0.11 to 0.41, p<0.001), both of which are associated with LAS injury risk. Furthermore, alterations in frontal plane kinetics (g=0.41, 95% CI 0.03 to 0.79, p=0.033) and sagittal plane kinematics (g=0.30, 95% CI 0.11 to 0.50, p=0.002) were observed in individuals approximately 2 years following concussion, both of which are associated with ACL injury risk. The moderator analyses indicated cognitive demands (ie, working memory, inhibitory control tasks) affected frontal plane kinematics (p=0.009), but not sagittal plane kinematics and locomotion-related performance, between the concussion and non-concussion groups. Conclusion: Following a recent concussion, individuals display decreased postural stability and slower locomotion-related performance, both of which are associated with LAS injury risk. Moreover, individuals within 2 years following a concussion also adopt a more erect landing posture with greater knee internal adduction moment, both of which are associated with ACL injury risk. While adding cognitive demands to jump-landing tasks affected frontal plane kinematics during landing, the altered movement patterns in locomotion and sagittal plane kinematics postconcussion persisted regardless of additional cognitive demands. Prospero Registration Number: CRD42021248916. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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