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Background Recent evidence has identified a ~2-fold elevated risk of musculoskeletal injury (MSKI) in the year following a concussion. Individual factors have generally been unsuccessful in identifying athletes at elevated MSKI risk. Objective To develop a risk profile for post-concussion MSKI Design Prospective and longitudinal. Setting Collegiate Athletics in the United States Participants We tracked 66 student-athletes (35 F, 31 M; Age: 20.0 + 1.1 y.o., Ht: 174.9 + 11.0 cm, Wt: 78.7 + 20.9 kg) for one year following a concussion. Assessments of Risk Factors We recorded common data elements from concussion management and categorized them into Balance, Cognition, Vestibular, and Psychosocial measures. We applied a sufficient dimension reduction statistical model to identify a composite risk score for athletes who experienced a subsequent MSK (N=36) and no subsequent MSK (N=30). Main Outcome Measures MSKI was defined as any injury recorded by the athletic training or team physician which resulted in at least one day of limited participation. An independent samples t-test compared a normalized composite risk score between subsequent MSK injured vs uninjured. An ROC analysis was performed on the composite scores. Results There was a significant difference in the normalized composite score between groups (No-MSKI: 4.1 + 3.2 and MSKI -5.5 + 2.9, p=0.042) with a lower score indicating worse overall performance. The highest ROC value (0.72) came from a combination of ImPACT Motor Speed and the Trail Making Test-A. Conclusions There is strong evidence in the literature for an elevated risk of post-concussion MSKI; however, prediction models have been unsuccessful. The results of this study provide initial evidence that a model combining assessments can differentiate those who experience subsequent MSKI. Future studies need to incorporate additional measures (e.g., medical history, sex, injury characteristics) and may allow health care providers to target athletes at the highest injury risk.
Buckley et al. (Fri,) studied this question.