No Clinical Predictors of Post-concussion Musculoskeletal Injury in College Athletes

Med Sci Sports Exerc -

Buckley, T. A., Howard, C. M., Oldham, J. R., Lynall, R. C., Swanik, C. B., & Getchell, N..




To identify clinical predictors of post-concussion subsequent musculoskeletal (MSK) injuries.


We recruited 66 NCAA intercollegiate student-athletes with a diagnosed concussion as well as 36 NCAA student-athletes without a concussion. All participants completed a multifaceted concussion baseline consisting of 1) 22-item 0-6 self-reported symptom checklist with outcomes including both the number of symptoms endorsed (0 – 22) and 2) total symptom score (0 – 132), 3) Standard Assessment of Concussion (SAC), 4) Balance Error Scoring System (BESS), 5) Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), 6) clinical reaction time (CRT), and 7) the King-Devick (KD) as well as demographic and injury characteristics. The concussion participants completed the same exam acutely post-concussion and binary logistic regression was used to identify predictors of subsequent MSK from the change scores (Acute minus Baseline). From the 66 concussed student-athletes, a subset 36, matched with the healthy athletes, compared the risk of subsequent MSK in the year prior to and year following their concussion.


The concussion participants were 1.78x (95% CI: 1.12 – 2.84, p=0.015) more likely to suffer a LE MSK in the year following their concussion then the control participants. The participant demographics and injury characteristics (p=0.318) and concussion clinical outcomes (p=0.461) did not predict subsequent MSK.


The concussion participants were 1.78x more likely to sustain a subsequent MSK; however, no demographic, injury characteristic, or concussion assessments predicted the MSK. Thus, clinicians are not able to utilize common neurological measures or participant demographics to identify those at risk for subsequent LE MSK. Injury prevention strategies should be considered for collegiate student-athletes upon RTP following a concussion to reduce the subsequent MSK.

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