Anticipatory head control mechanisms in response to impact perturbations: An investigation of club rugby players with and without a history of concussion injury. (January 2023) - Bussey, Melanie D.
Abstract: Objectives: The primary objective of this study was to examine rugby players anticipatory and compensatory head control during predictable and unpredictable impact events. Methods: An observational cross-sectional study design. Fifty-one (17_healthy 34_concussion) male rugby players were exposed to external predictable and unpredictable impact perturbations at mid-chest level. Surface EMG of the upper-trapezius (UT), splenius-capitis (Spl) and sternocleidomastoid (Scm) was recorded and analysed across three temporal epochs typical for anticipatory and compensatory postural control. Synchronized sagittal head-kinematics were measured from high-speed video (500 fps). Nonparametric tests were used to examine within and between group effects. Results: Anticipatory head control was evident in predictable conditions, expressed by early posterior head displacement and activation of the Spl. Compared to unpredictable conditions, muscle amplitudes were significantly lower, as was head acceleration. Compared to Healthy, the Concussion athletes lacked early activation of the Spl, exhibited delayed anticipatory head adjustments and experienced higher head accelerations in predictable conditions. Conclusion: Rugby players with concussion injuries have significant deficits in cervical spinal motor control. The concussed motor control strategy leads to higher inertial head accelerations and delayed anticipatory head displacements. Effects may persist for two or more years following injury, which may indicate re-injury vulnerability in these athletes. Highlights: Anticipatory postural head adjustments aid in reducing head acceleration and displacement during inertial impact events. Rugby players exhibit an anticipatory postural head adjustment in predictable impact events. Players with concussion history have weak or delayed anticipatory postural head control. Concussion injury has a significant impact on anticipatory cervical spinal control up to two years post-diagnosis.