A Sport Fitness Index for Assessment of Sport-Related Injury Risk

Wilkerson, Gary B.; Colston, Marisa A.; Baker, Carrie Silkman

doi:10.1097/jsm.0000000000000280

Cited by 20 publications

(18 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The Institutional Review Board of the University of Tennessee at Chattanooga approved all study procedures. Surveys administered prior to initiation of the first training session included the Sports Fitness Index (Wilkerson et al, 2016), the Overall Wellness Index (Wilkerson et al, 2021b), and the Depression, Anxiety, and Stress Scale (Edmed and Sullivan, 2012), which were used to confirm greater frequency of selfreported problems among the athletes who affirmed a history of at least one SRC (HxSRC).…”

Section: Methodsmentioning

confidence: 99%

A Novel Approach to Assessment of Perceptual-Motor Efficiency and Training-Induced Improvement in the Performance Capabilities of Elite Athletes

Wilkerson

Nabhan

Perry

2021

Front. Sports Act. Living

Self Cite

View full text Add to dashboard Cite

Standard clinical assessments of mild traumatic brain injury are inadequate to detect subtle abnormalities that can be revealed by sophisticated diagnostic technology. An association has been observed between sport-related concussion (SRC) and subsequent musculoskeletal injury, but the underlying neurophysiological mechanism is not currently understood. A cohort of 16 elite athletes (10 male, 6 female), which included nine individuals who reported a history of SRC (5 male, 4 female) that occurred between 4 months and 8 years earlier, volunteered to participate in a 12-session program for assessment and training of perceptual-motor efficiency. Performance metrics derived from single- and dual-task whole-body lateral and diagonal reactive movements to virtual reality targets in left and right directions were analyzed separately and combined in various ways to create composite representations of global function. Intra-individual variability across performance domains demonstrated very good SRC history classification accuracy for the earliest 3-session phase of the program (Reaction Time Dispersion AUC = 0.841; Deceleration Dispersion AUC = 0.810; Reaction Time Discrepancy AUC = 0.825, Deceleration Discrepancy AUC = 0.794). Good earliest phase discrimination was also found for Composite Asymmetry between left and right movement directions (AUC = 0.778) and Excursion Average distance beyond the minimal body displacement necessary for virtual target deactivation (AUC = 0.730). Sensitivity derived from Youden's Index for the 6 global factors ranged from 67 to 89% and an identical specificity value of 86% for all of them. Median values demonstrated substantial improvement from the first 3-session phase to the last 3-session phase for Composite Asymmetry and Excursion Average. The results suggest that a Composite Asymmetry value ≥ 0.15 and an Excursion Average value ≥ 7 m, provide reasonable qualitative approximations for clinical identification of suboptimal perceptual-motor performance. Despite acknowledged study limitations, the findings support a hypothesized relationship between whole-body reactive agility performance and functional connectivity among brain networks subserving sensory perception, cognitive decision-making, and motor execution. A complex systems approach appears to perform better than traditional data analysis methods for detection of subtle perceptual-motor impairment, which has the potential to advance both clinical management of SRC and training for performance enhancement.

show abstract

Section: Methodsmentioning

confidence: 99%

A Novel Approach to Assessment of Perceptual-Motor Efficiency and Training-Induced Improvement in the Performance Capabilities of Elite Athletes

Wilkerson

Nabhan

Perry

2021

Front. Sports Act. Living

Self Cite

View full text Add to dashboard Cite

show abstract

“…The surveys used were the Sport Fitness Index, 29 which contains questions about SRC Hx and MSK Hx, and the Depression Anxiety Stress Scale. 30 The athletes performed 60-second VMRT tests during which they manually contacted randomly illuminated buttons on a heightadjustable board (model D2 System; Dynavision International, West Chester, OH) and WBRA tests requiring lateral or diagonal movements in response to the appearance of visual targets on a virtual-reality display (model TRAZER Sports Stimulator; Traq Global Ltd, Westlake, OH).…”

Section: Methodsmentioning

confidence: 99%

Concussion History and Neuromechanical Responsiveness Asymmetry

Wilkerson

Nabhan

Crane

2020

Journal of Athletic Training

Self Cite

View full text Add to dashboard Cite

Context Detection of subtle changes in brain sensorimotor processes may enable clinicians to identify athletes who would derive the greatest benefit from interventions designed to reduce the risk for future injury and progressive neurologic or musculoskeletal dysfunction. Objective To develop a generalizable statistical model for identifying athletes who possess subtle alterations in sensorimotor processes that may be due to previous concussion. Design Cross-sectional study. Setting Residential Olympic Training Center sports medicine clinic. Patients or Other Participants A primary cohort of 35 elite athletes and a secondary cohort of 40 elite athletes who performed identical tests the preceding year. Intervention(s) Two upper extremity tests of visual-motor reaction time and 2 tests of whole-body reactive agility were administered. The whole-body tests required lateral or diagonal responses to virtual-reality targets, which provided measures of reaction time, speed, acceleration, and deceleration. Main Outcome Measure(s) Sport-related concussion history, which was reported by 54% (n = 19) of the athletes in the primary cohort and 45% (n = 18) of the athletes in the secondary cohort. Results Univariable analyses identified 12 strong predictors of sport-related concussion history, which we combined to create a composite metric with maximum predictive value. Composite lateral asymmetry for whole-body reactive movements and persisting effects of previous musculoskeletal injury yielded a logistic regression model with exceptionally good discrimination (area under the curve = 0.845) and calibration (predicted-observed probabilities within 7 subgroups: r = 0.959, P = .001). Application of the derived model to compatible data acquired from another cohort of elite athletes demonstrated very good discrimination (area under the curve = 0.772) and calibration (within 8 subgroups: r = 0.849, P = .008). Conclusions Asymmetry in whole-body reactive movement capabilities may be a manifestation of a subtle abnormality in the functional connectivity of brain networks that might be relevant to previously reported associations between sport-related concussion history and musculoskeletal injury occurrence.

show abstract

“…'At-risk' was defined as below a cutpoint for standing long jump (SLJ) and lower extremity functional test (LEFT) for lower quarter injuries and below a cut-point for SLJ, LEFT, and single hop for thigh and knee injuries. Future research should consider including the triple hop in test clusters to define 'at-risk' studentathletes combined with training factors known to be associated with injury including training load,(9,11) fitness, (39,40) for early identification for delivery and evaluation of injury prevention interventions.…”

Section: Discussionmentioning

confidence: 99%

Association of Functional Screening Tests and Noncontact Injuries in Division I Women Student-Athletes

Warren

Lininger

Smith

et al. 2020

Journal of Strength and Conditioning Research

View full text Add to dashboard Cite

To determine the association between functional screening tests and lower body, non-contact injuries in Division I women basketball, soccer, and volleyball student-athletes (SA). 68 injury-free women SA (age:19.1±1.1 yrs, height:171.3±8.7 cm, mass:68.4± 9.5 kg) were tested preseason with single (SH), triple (TH), and crossover (XH) hop for distance, and isometric hip strength (abduction, extension, and external rotation) in randomized order. The first lower body (spine and lower extremity), non-contact injury requiring intervention by the athletic trainer was abstracted from the electronic medical record. Receiver operating characteristic and area under the curve (AUC) were calculated to determine cut-points for each hopping test from the absolute value of between limb difference. Body weight-adjusted strength was categorized into tertiles. Logistic regression determined the odds of injury with each functional screening test using the hopping tests cut-points and strength categories, adjusting for previous injury history. 52 SA were injured during the sport season. The cut-point for SH was 4 cm (sensitivity=0.77, specificity=0.43, AUC=0.53), and TH and XH was 12 cm (sensitivity=0.75 and 0.67, specificity=0.71 and 0.57, AUC=0.59 and 0.41, respectively). A statistically significant association with TH and injuries (adjusted odds ratio=6.50 [95% confidence interval:1.69-25.04]) was found. No significant overall association was found with SH or XH, nor with the strength tests.Using a clinically relevant injury definition, the TH showed the strongest predictive ability for non-contact injuries. This hopping test may be a clinically useful tool to help identify increased risk of injury in women SA participating in high-risk sports.

show abstract

A Sport Fitness Index for Assessment of Sport-Related Injury Risk

Abstract: Self-reported effects of previous injury may be one method to efficiently identify athletes who possess elevated injury risk, and subsequently deliver preventive interventions, thereby providing an alternative method to time-intensive functional testing.

Cited by 20 publications

References 35 publications

A Novel Approach to Assessment of Perceptual-Motor Efficiency and Training-Induced Improvement in the Performance Capabilities of Elite Athletes

A Novel Approach to Assessment of Perceptual-Motor Efficiency and Training-Induced Improvement in the Performance Capabilities of Elite Athletes

Concussion History and Neuromechanical Responsiveness Asymmetry

Association of Functional Screening Tests and Noncontact Injuries in Division I Women Student-Athletes

Contact Info

Product

Resources

About