这项工作是支持的，由NIBIB（EB007954）和杰拉尔丁华纳慈善捐赠的一部分。

下面描述的协议有一个视力训练程序，它是在所有的UC运动员进行基线测试的一部分的组件。一些组件进行了研究，研究试验，并在这些情况下，协议批准了UC机构审查委员会和科目签署知情同意书的陈述。 1.光板视觉训练这大约需要8分钟才能完成本次培训。 <ol><li> *一个程序8-11 <ol><li>直接受站在约18英寸远离光板，并有受力争达到灯火通明的外圈。移动对象靠近或远离，如果需要，以达到所有的灯。此外，移动光板上下使用电源开关的一侧，使拍摄对象处于眼平在电路板上的屏幕。 让主体立场的准备位置，以便能够打灯。有主题握住他/她的手到胸部水平定位的手在环的中心。 </li><li>指示受试者对撞用双手尽可能快的灯和停用尽可能多的在一分钟。每个灯将保持照明，直到命中。 注意:当主体成功击中一个光有它们可以在除了关灯听到嘟嘟声。 </li><li>有临床医生选择*的程序，并有受击（停用）尽可能多的灯光尽可能在一分钟。随着经验的积累主题将成为舒适的菜单系统，并能够从医生开始*一个没有援助，如果需要的话。 </li><li>记录每分钟的命中件数为每个会话连同一分钟测试期间的平均反应时间在为命中秒追踪进展。 </li></ol></li><li>反应测试计划11 注:反应测试程序包括六个不同的测试，三层为右击吨手和三个用于左手。 <ol><li>指示标的选择反应测试和命中开始。该灯测试1R（右手）将依次亮起三次，以显示这灯，他们将被击中的主题。一旦灯被完成闪烁顺序，将有一个光将点亮第一测试的权利。四个水平灯中心环的左侧被用于测试1R和四到中心的右侧被用于测试1L。 </li><li>指示须按住点燃光权（右手）挡在面前，在灯光的行是在演示过程中点燃了中间。有主题举行左手背后他/她的背部。 </li><li>有主题扫描点亮期间示范序列四横灯。其中的四个指示灯将亮起，随机在五秒钟内。水平行中的每个光之间的距离是14英寸。有主体移动右手从初始光到反应轻尽快和停用它（ 图1A - C）。 </li><li>一旦完成主体命中一个预先确定的数量，一般为5次，指示他/她按绿色光灯的内圈的底部。这将显示该灯为下一个测试将所涉及的主题。当准备好后，受试者按住点燃光在左侧，保持背后的右边，并遵循上述程序。指出的主题在这些测试无视底部绿灯，因为它是从使用一个测试改变到另一种，但不是一个指示灯被击中。 注:测试1R和1L涉及线性随机目标开关。测试2R和2L再次随机的，未知的目标，这将出现在沿线的八个不同的飞机之一的弧线。它是用于测试2R和2L灯的中间环。测试3R和3L是一个简单的光选择使用灯光的T-范围左右。 </li><li>记录平均反应时间为每个试验外加的总体反应时间。 </li></ol></li><li>震荡1-3项目（由笔者JFC开发新的程序）。 注:三个程序被设计为按顺序执行。学习效果被认为是在正常个体。然而，在震荡患者的学习效果是没有看到，被认为是诊断为脑震荡。这些程序被用于测试，不训练。对于脑震荡测试Dynavision * A和Dynavision反应测试可以用于基线评估。三个震荡测试也用于脑震荡评估，但通常不是由受试者提前完成。这三个测试震荡被设计为多任务处理和执行功能测试，受试者7以前没有见过的。 <ol><li>进行震荡1程序，仅使用中间苏氨酸一分钟的测试ee值同心环。测试是类似于*的测试，除了受试者具有个位数（随机数1到9）闪烁可编程屏上一秒八秒的时间间隔。让拍摄对象读取数字闪现在屏幕上大声测试仪，同时还创下了有灯光的按钮。所得分数是每分钟命中件数和未接来电的报告（如有的话）。 </li><li>进行震荡2方案，这是在屏幕的个位数的闪存类似脑震荡1。指导受试者呼出的第一个数字，同时还创下按钮，记住它，然后当第二个数字闪烁，加在一起的第一和第二号，调出数字的总和。受试者继续打按钮同时呼吁和对添加数字。 </li><li>进行震荡3方案，这是类似于震荡2与一个额外的任务;的按钮中的20％是绿色的。主题是责成击中按钮和成对类似于1.3.2的说明添加数字。除了这些任务，指导受打绿色按钮，也叫出来的绿色环保。因此，有两个讲任务，呼吁环保，同时呼吁在对添加数字。这同时击中按钮的颜色都被全部完成。 </li></ol></li></ol> 2. Brock的字符串6,10,12 <ol><li>握住布洛克串的一端上的受验者的鼻子的前端，而另一端被连接到一个固定点。固定点可以是水平，升高的或相对于鼻点的高度下降。中性是直行（水平）。向上或向下的角度不应该是在任一方向上超过45度。最初的字符串被保持在水平位置，然后通常仰角从10°进展到25°〜45°以上的时间帧，其中任务是具有挑战性的，但仍舒适。风趣^ h有些人谁拥有突出的鼻子或眼睛眉毛有可能是需要遵守的解剖限制。 </li><li>空间上串的长度至少为12英寸的距离开始从鼻子约10英寸的五个彩色珠子。指示受试者对备用音响xation和从一胎圈焦点移到下一个而（在单个点处形成的图像的）记录每个眼球和收敛感觉的视觉输入。的测量没有记录，因为这是作为一个练习，而不是测试。 <ol><li>根据当事人的需要而变化的间距。需求可以基于运动或任务。例如，打击运动，如拳击可能需要更多的珠子不到3英尺的距离，而场运动，如足球和足球可能需要大约10英尺（ 图2A - C）珠。 </li></ol></li><li>另外，使用一个任务，其中的字符串是六英尺在一端打结。很多人都从他们的鼻子达到自己的f的尖4英尺ingers。最远的珠子被放置在极端到达食指。受试者接触珠用他的食指和它返回到腿的侧面，交替的左，右手。 </li><li>或者，使用棒用胶带的球的颜色上的布洛克串。空间磁带3英寸分开。当进行运动，指示受试者对匹配在棒球的颜色带的颜色，呼叫每个颜色，因为他匹配球到磁带上。 </li></ol> 3. EYEPORT培训13 <ol><li>对于训练1，地点交替的红色和蓝色的线性灯在水平位置，并指示受试者对坐24至30英寸的系统。有主题按下回车键，听到蜂鸣声10，然后按照灯带他/她的眼睛。当运动结束的主题将听到蜂鸣声，然后应关闭他/她的眼睛和休息，直到下一个练习。 </li><li>对于培训2，PLACË线性灯在垂直位置，重复步骤练习1。 </li><li>对于培训3，旋转灯线性向左侧从垂直位置，重复步骤练习1.转动通过360°做过阶段。常见阶段是20度的时间，条件是具有舒适的主题。 </li><li>对于训练4，旋转线性灯从垂直位置向右侧，并重复步骤练习1。 </li><li>对于培训5，重新定位线性灯，以便系统涉及主体的鼻子的末端。指示须遵循近灯和远远至近。 注意:每次运动前都要到下一个后指导的主题休息。的测量没有记录，因为这是作为一个练习，而不是测试。 </li></ol> 4.宽松的脚蹼<ol><li>让受磨损他/她的习惯性处方。完成所有的训练双眼。的f的功率使用理柏透镜被改变，以优化的训练效果。所使用的两个大国应该是具有挑战性的，但不是繁琐的重点对象上的鳍状肢交替。 </li><li>指示须持有10×10扫视图表14英寸的平面奇观。 </li><li>指示主题阅读从左至右，而移动的鳍状肢上下反复。蛙鞋移动后才主题可重点关注并阅读扫视卡。 </li><li>测试一分钟或直至第100字符为止。 </li><li>算并记录读取在一分钟的字符数或注意它需要读100的时间。 </li></ol> 5速示器注:本次培训采用的是PowerPoint演示文稿由作者Ĵ克拉克设计。 <ol><li>有主题观看演示定时，使一个或两个基于flash后提出的问题的信息的特定位音符。通常几个主题Ç上同时投影速示训练的工作。 </li><li>由于脑子里闪过图片有数字和字母或随机分布在整个画面，让主体注意数字/字母。此外，问其他问题，例如从照片的玩家数量，球队正在播放等。 </li><li>使速示训练逐步更复杂，通过使闪光时间短和/或将要获得的信息更复杂。 （ 图3A和B）。正确的回答问题的比例可以记录。 </li></ol> 6.针孔眼镜或眼镜频闪与节距和追赶<ol><li>给受试者群体，大致2〜六个科目，有1或2个球，针孔眼镜（ 图4A）或闪光灯眼镜（ 图4B），并建议把球（S）左右，每节大约2-5分钟。 （ 图4C和&lt;STRONG&gt; 4D）两到三次，每周的会议可以执行。 </li><li>如果频闪眼镜和眼镜针孔可用，有科目旋转闪光灯和针孔眼镜每隔一两分钟。频闪闪光玻璃启动速度，以较快的速度，并放缓使工作更具挑战性。当前选通眼镜有8个速度这样典型的起始速度是1或2，且被减速到速度4至6。 </li><li>通过在整个会议的音调和捕捞任务进度通过改变闪光灯的闪光的速度或缩小的针孔眼镜的视野。 </li><li>此外，还要通过让受试者转离他们的合作伙伴，并有转身追赶的间距和catch程序更加复杂。的测量没有记录，因为这是作为一个练习，而不是测试。 </li></ol> 7.眼跳运动训练6,10,14 <ol><li>位置的被检8英尺距眼跳的图表和中心之间的两个扫视图表，其从中心线大约8英尺的位置。在此之前开始锻炼，确保主体具有全方位眼部运动才能看到的扫视图表上的所有字母。调整从图表的距离相应地获得图表满怀憧憬。 注意:改变距离为动态组件添加到调节系统，因此受试者被要求至8英尺远站，而不是用于光板训练18英寸是很重要的。有视力训练计划，在那里，只使用一台电脑和电脑屏幕和不运动的调节系统。因此，在不同任务所进行的长度。每个扫视图表建在纸上的8.5×11英寸的片材。每个图表都有10个字母中每垂直线上的36点的字体与图表10的垂直线（ 图5）。 </li><li>指示主题阅读图表每个一分钟，保持他/她的头仍然只有移动他/她的眼睛。向受试者对读出的第一图表上的第一行中的第一个字母，然后交替到第二图表来读取第一行的第一个字母。这样就完成了一个循环。 </li><li>指示主题阅读左图其次为左右图表的第二个字母的第二个字母。这样就完成了一个循环。图表和字母跨线水平进步之间交替。由于受试者完成两个图表的第一线，指导他们移动到下一行， 等等 ，一分钟。记录周期中一分钟完成的数量。 </li><li>将图在视线水平和距离他们6英尺分开。这个演习的进展，包括使用不稳定的表面和图表的不同位置，以增强眼睛的速度和视觉焦点。 </li></ol> 8.近远培训6,10,14 <ol><li>利用两个图表为这项工作 -一个大的图表和一个较小的一个。使用眼跳图表大图。构造在一张3.5×2.5英寸的片材，其中有10个字母中每垂直线12点的字体与图表10的垂直线的小图表。 </li><li>修复图表远在视线水平的主题定位10英尺从图表。让主体持有近图表，用一只手大约4-6英寸的鼻子。这允许受看到在靠近图看，远图表（ 图6A）。 </li><li>指示的主题，以保持他的头还在，只移动双眼。向受试者阅读对远图表的第一行的第一个字母，然后交替到近图表来读取第一行的第一个字母。此完成一个循环（ 图6B和6C）。 </li><li>有受扫描眼睛看远图表随后不久图表的第二个字母的第二个字母。这样就完成了另一循环。 </li><li>指示受图表和文字跨行进展水平之间交替。作为两个图表的第一线建成后，有主体移动到下一行，直到时间结束的一分钟的会议。记录周期中一分钟完成的数量。 </li><li>指示的主题，以确保双眼交替从图表图表时成为焦点，在不久的目标，以及远的目标。 </li></ol> 9.立体视觉<ol><li>广场上的主题偏光眼镜，并询问是否"立体声飞翔的翅膀似乎站在了他们，并在三个方面？" </li><li>指导受试者观察立体飞在14英寸从他们的鼻子的距离。如果反应是积极的，指导科目"伸手点用钢笔立体声飞的右机翼翼尖，并持有该位置"（ 图7A）。 </li><li>记录的距离之间的照片和压紧的带毫米标尺（ 图7B）的中心。 注:数字越高，单位为毫米，当上了立体测得飞15指示更好的立体感。根据我们的经验，我们已发现，85毫米似乎是从照片到夹送3的中心的距离的上限。 </li></ol>

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W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Estimation+of+the+stereoscopic+threshold+utilizing+perceived+depth.">Estimation of the stereoscopic threshold utilizing perceived depth.</a> Ophthal Physiol Opt. 4 (3), 245-250 (1984).</li><li>Bigsby, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+postural+control+manipulation+on+visuomotor+training+performance:+comparative+data+in+healthy+athletes.">Effects of postural control manipulation on visuomotor training performance: comparative data in healthy athletes.</a> Int J Sports Phys Ther. 9 (4), 436-446 (2014).</li><li>Wells, A. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reliability+of+the+Dynavision+D2+for+Assessing+Reaction+Time+Performance.">Reliability of the Dynavision D2 for Assessing Reaction Time Performance.</a> J Sports Sci and Med. 13, 145-150 (2014).</li><li>Guskiewicz, K. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=National+Athletic+Trainers&#8217;+Association+Position+Statement:+Management+of+Sport-Related+Concussion.">National Athletic Trainers&#8217; Association Position Statement: Management of Sport-Related Concussion.</a> J Athletic Training. 39 (3), 280-297 (2004).</li><li>Kuhn, A. W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Supervision+and+computerized+neurocognitive+baseline+test+performance+in+high+school+athletes:+an+initial+investigation.">Supervision and computerized neurocognitive baseline test performance in high school athletes: an initial investigation.</a> J Athl Train. 49 (6), 800-805 (2014).</li><li>Reed, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+multi-modal+approach+to+assessing+recovery+in+youth+athletes+following+concussion.">A multi-modal approach to assessing recovery in youth athletes following concussion.</a> J Vis Exp. (91), 51892 (2014).</li><li>Fleisig, G. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Kinetic+comparison+among+the+fastball,+curveball,+change-up,+and+slider+in+collegiate+baseball+pitchers.">Kinetic comparison among the fastball, curveball, change-up, and slider in collegiate baseball pitchers.</a> Am J Sports Med. 34 (3), 423-430 (2006).</li><li>Gray, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=How+do+batters+use+visual,+auditory,+and+tactile+information+about+the+success+of+a+baseball+swing.">How do batters use visual, auditory, and tactile information about the success of a baseball swing.</a> Res Q Exerc Sport. 80 (3), 491-501 (2009).</li><li>Kato, T., Fukuda, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Visual+search+strategies+of+baseball+batters:+eye+movements+during+the+preparatory+phase+of+batting.">Visual search strategies of baseball batters: eye movements during the preparatory phase of batting.</a> Mot Skills. 94 (2), 380-386 (2002).</li><li>Howard, I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Perceiving in Depth. , 978-970 (2012).</li></ol>

The authors have nothing to disclose.
The Dynavision D2 may be a tool that clinical practitioners can use to provide added information concerning neurologic health of the athlete with a concussion10,22,23,27. The device does not make the diagnosis but assists the clinician in making a clinical decision by providing objective measures of the performance parameters for that patient or athlete.

视力训练，当作为一个团队运动广泛开展，相对于球员谁不接受视力训练7减小这些球员脑震荡的发生。视力训练生成可定量地监测以评估训练的成功，并可以启动为震荡预防运动医学干预的一部分功能和性能的变化。功能的改变是改变在测量时，用于在视力训练记录例如更快的反应时间。我们的目标是在性能，改变诸如改进的性能变化时卡扣掉球被提高。 提供的视?...

视力训练，包括使用光板视觉系统，已经得到普及，以改善运动性能1,2的手段。光板系统通常用于康复脑损伤后2,3和运动性能增强作为视觉训练方案1,4,5的一部分。视力训练也被用来作为预防伤害6的手段。 辛辛那提大学（UC）运动医学科已经用一个光板视觉工具震荡的管理，诊断，回打决策，伤害预防和运动员的康复和性能增强3,5,7。每个运动员都有在赛季初收集基线测量，并使用这些值的震荡管理计划的一部分，专门针对运动员的脑震荡后评估和治疗。其中一个工具的优势之一是OBJE莫如数据收集:单位时间内的点击数，每一击，每击平均反应时间，多任务演练和时间输出观测进步的视野之内的位置。 加州大学运动医学团队使用了* A和反应试验的震荡基线评估的一部分。另外三个，专门建造的，程序也可用于脑震荡诊断。这些被称为震荡1，震荡2和震荡3 3震荡测试并不需要包括季前赛基准测试中，因为复杂的各自不同的级别允许每个测试结果，以作为其他集合中的一个引用。 当程序补充额外的视觉训练方法运动员得到了全面的培训和临床医生获得在震荡的情况下，丰富的基线数据。几个额外的视觉训练方法完成的综合方案:布洛克的字符串，EYEPORT培训，宽松的脚蹼，速示器，针孔眼镜或眼镜频闪用沥青和捕捉，扫视眼球运动训练，远近培训。本文介绍视力训练方法与无轻载系统，规范的数据为关于使用视力训练协议为脑震荡管理计划的一部分，科大学1足球运动员，并期望和协议基准结果。

<table><tbody><tr><td>Dynavision D2</td><td>Dynavision International</td><td></td><td>&lt;a href=&quot;http://dynavisioninternational.com/shop.html&quot;&gt;External Link&lt;/a&gt;</td></tr><tr><td>EYEPORT Vision Training System</td><td>Exercise Your Eyes, Dove Canyon, CA</td><td></td><td>&lt;a href=&quot;http://www.promolife.com/cart/eyeport-vision-training-system&quot;&gt;External Link&lt;/a&gt;</td></tr><tr><td>accommodative flippers</td><td>Various manufacturers</td><td></td><td>&lt;a href=&quot;http://www.amconlabs.com/product.asp?pid=4511&amp;amp;categoryname=&amp;amp;prodCatFrom=206&quot;&gt;External Link&lt;/a&gt;</td></tr><tr><td>pinhole glasses</td><td>Various manufacturers</td><td></td><td>&lt;a href=&quot;https://www.bernell.com/product/394/335&quot;&gt;External Link&lt;/a&gt;</td></tr><tr><td>strobe glasses - Nike Sparq</td><td>Nike&amp;nbsp;</td><td></td><td>&lt;a href=&quot;http://palmensports.com/order-the-nike-sparq-vapor-strobes-eyewear/&quot;&gt;External Link &lt;/a&gt;</td></tr></tbody></table>

vision training methods for sports concussion mitigation and management

越来越多的证据支持使用视力训练，包括光板培训工具，如脑震荡基线和神经诊断工具，并可能作为支持性组件震荡预防策略。本文的重点是提供详细的方法选择视力训练工具和报告规范的数据进行比较时，视觉训练是体育管理程序的一部分。整体方案包括标准视力的训练方法，包括速示器，布洛克的字符串，频闪眼镜，以及专门的光板训练算法。立体测量为监测视力训练影响的一种手段。此外，报告对视力的训练方法定量结果，以及与进步的分数基线和后期测试* A和反应测试测量。大学生运动员不断改善六个星期的训练在他们的立体视觉，* A和反应测试成绩后。当愿景训练开始作为一个团队运动广，震荡下跌的球员谁参加培训相比，球员谁不接受视力训练的发病率。视力训练产生功能和性能的变化是，监测时，可以用来评估视力训练的成功，并可以启动为震荡预防运动医疗干预的一部分。

棒球，足球和志愿受试者都参加了视力训练计划。所有受试者已经大学年龄段的男性或女性，18- 26岁之间的年龄。 足球平均*分数为101 UC足球运动员，他们执行的是74.2±10.3命中每分钟（HPM），平均反应时间测试为他们的第一次表演是0.34±0.03秒（N = 79的第一次，注意不是所有玩家105有机会完成反应测试）。 六十三名球员暴露于多岁光?...

Watch this Scientific Journal Video about Vision Training Methods for Sports Concussion Mitigation and Management at JoVE.com

Vision Training Methods for Sports Concussion Mitigation and Management

This paper describes a protocol to conduct, quantitatively monitor, and assess the success of vision training initiated as part of a sports medical management program including intervention for concussion prevention and performance enhancement.

视觉训练方法体育震荡缓解与管理

There is emerging evidence supporting the use vision training, including light board training tools, as a concussion baseline and neuro-diagnostic tool ...

vision-training-methods-for-sports-concussion-mitigation

Research

JoVE Journal

Behavior

17.3K 次观看.  University of Cincinnati. This paper describes a protocol to conduct, quantitatively monitor, and assess the success of vision training initiated as part of a sports medical management program including intervention for concussion prevention and performance enhancement.

视频: Vision Training Methods for Sports Concussion Mitigation and Management

An Investigation of the Effects of Sports-related Concussion in Youth Using Functional Magnetic Resonance Imaging and the Head Impact Telemetry System

One of the most commonly reported injuries in children who participate in sports is concussion or mild traumatic brain injury (mTBI)1. Children and youth involved in organized sports such as competitive hockey are nearly six times more likely to suffer a severe concussion compared to children involved in other leisure physical activities2. While the most common cognitive sequelae of mTBI appear similar for children and adults, the recovery profile and breadth of consequences in children remains largely unknown2, as does the influence of pre-injury characteristics (e.g. gender) and injury details (e.g. magnitude and direction of impact) on long-term outcomes. Competitive sports, such as hockey, allow the rare opportunity to utilize a pre-post design to obtain pre-injury data before concussion occurs on youth characteristics and functioning and to relate this to outcome following injury. Our primary goals are to refine pediatric concussion diagnosis and management based on research evidence that is specific to children and youth. To do this we use new, multi-modal and integrative approaches that will:
 1.Evaluate the immediate effects of head trauma in youth 
2.Monitor the resolution of post-concussion symptoms (PCS) and cognitive performance during recovery 
3.Utilize new methods to verify brain injury and recovery
To achieve our goals, we have implemented the Head Impact Telemetry (HIT) System. (Simbex; Lebanon, NH, USA). This system equips commercially available Easton S9 hockey helmets (Easton-Bell Sports; Van Nuys, CA, USA) with single-axis accelerometers designed to measure real-time head accelerations during contact sport participation 3 - 5. By using telemetric technology, the magnitude of acceleration and location of all head impacts during sport participation can be objectively detected and recorded. We also use functional magnetic resonance imaging (fMRI) to localize and assess changes in neural activity specifically in the medial temporal and frontal lobes during the performance of cognitive tasks, since those are the cerebral regions most sensitive to concussive head injury 6. Finally, we are acquiring structural imaging data sensitive to damage in brain white matter.

This article provides an overview of a multi-modal approach to mild traumatic brain injury diagnosis and recovery in youth. This approach combines neuropsychological testing with functional magnetic resonance imaging and the Head Impact Telemetry System to monitor the relationship between head impacts and brain activity during cognitive testing.

在使用功能性磁共振成像和头部撞击遥测系统的青年与体育有关的震荡影响的调查

One of the most commonly reported injuries in children who participate in sports is concussion or mild traumatic brain injury (mTBI)1. Children and youth ...

科研

医学

Combined Shuttle-Box Training with Electrophysiological Cortex Recording and Stimulation as a Tool to Study Perception and Learning

Shuttle-box avoidance learning is a well-established method in behavioral neuroscience and experimental setups were traditionally custom-made; the necessary equipment is now available by several commercial companies. This protocol provides a detailed description of a two-way shuttle-box avoidance learning paradigm in rodents (here Mongolian gerbils; Meriones unguiculatus) in combination with site-specific electrical intracortical microstimulation (ICMS) and simultaneous chronical electrophysiological in vivo recordings. The detailed protocol is applicable to study multiple aspects of learning behavior and perception in different rodent species.
Site-specific ICMS of auditory cortical circuits as conditioned stimuli here is used as a tool to test the perceptual relevance of specific afferent, efferent and intracortical connections. Distinct activation patterns can be evoked by using different stimulation electrode arrays for local, layer-dependent ICMS or distant ICMS sites. Utilizing behavioral signal detection analysis it can be determined which stimulation strategy is most effective for eliciting a behaviorally detectable and salient signal. Further, parallel multichannel-recordings using different electrode designs (surface electrodes, depth electrodes, etc.) allow for investigating neuronal observables over the time course of such learning processes. It will be discussed how changes of the behavioral design can increase the cognitive complexity (e.g. detection, discrimination, reversal learning).

Shuttle-box avoidance learning is well-established in behavioral neuroscience. This protocol describes how shuttle-box learning in rodents can be combined with site-specific electrical intracortical microstimulation (ICMS) and simultaneous chronical in vivo recordings as a tool to study multiple aspects of learning and perception.

联合穿梭盒子训练与电的Cortex记录和刺激作为一种工具来研究感知和学习

Shuttle-box avoidance learning is a well-established method in behavioral neuroscience and experimental setups were traditionally custom-made; the ...

行为学

In Vivo Protocol of Controlled Subconcussive Head Impacts for the Validation of Field Study Data

Subconcussive hits pose a threat to neuronal health as they have shown to induce neuronal structural damage and functional impairment without causing outward symptomology and appear to be a key contributor to an irreversible neurodegenerative disease, chronic traumatic encephalopathy (CTE). In addition, athletes can incur more than 1,000 of these hits per season. The subconcussive soccer heading model (SSHM) is a relevant, reproducible, and leading method of isolating and examining the effects of these subconcussive head impacts. By controlling variables such as ball traveling speed, the frequency of impacts, interval, ball placement to the head, as well as by measuring head impact magnitude, the SSHM provides the scientific community with a superior avenue of investigating the acute subconcussive effects on neuronal health. In this paper, we demonstrate the utility of SSHM in studying a time-course expression of neurofilament-light polypeptide (NF-L) in plasma in a repeated measures fashion. NF-L is an axonal injury marker that has previously been shown to be elevated in boxers and football players following subconcussive head trauma. Thirty-four adult aged soccer players were recruited and randomly assigned to either a soccer heading (n = 18) or kicking (n = 16) group. The heading group executed 10 headers with soccer balls projected at a velocity of 25 mph over 10 min. The kicking group followed the same protocol with 10 kicks. Plasma samples were obtained before and at 0 h, 2 h, and 24 h after heading/kicking and assessed for NF-L expressions. The heading group showed a gradual increase in plasma NF-L expression and peaked at 24 h after the heading protocol, whereas the kicking group remained consistent across the time points. These results confirmed the NF-L data from clinical field studies, encouraging the use of SSHM to validate clinical subconcussion data.

The subconcussive soccer heading model is a safe and concise methodological approach to isolate and measure the effects of subconcussive head impacts.

控制下冲击头冲击的活体协议对现场研究数据的验证

Subconcussive hits pose a threat to neuronal health as they have shown to induce neuronal structural damage and functional impairment without causing ...

Modified Drop Tower Impact Tests for American Football Helmets

A modified National Operating Committee on Standards for Athletic Equipment (NOCSAE) test method for American football helmet drop impact test standards is presented that would provide better assessment of a helmet's on-field impact performance by including a faceguard on the helmet. In this study, a merger of faceguard and helmet test standards is proposed. The need for a more robust systematic approach to football helmet testing procedures is emphasized by comparing representative results of the Head Injury Criterion (HIC), Severity Index (SI), and peak acceleration values for different helmets at different helmet locations under modified NOCSAE standard drop tower tests. Essentially, these comparative drop test results revealed that the faceguard adds a stiffening kinematic constraint to the shell that lessens total energy absorption. The current NOCSAE standard test methods can be improved to represent on-field helmet hits by attaching the faceguards to helmets and by including two new helmet impact locations (Front Top and Front Top Boss). The reported football helmet test method gives a more accurate representation of a helmet's performance and its ability to mitigate on-field impacts while promoting safer football helmets.

This article provides a novel technique to assess the performance characteristics of American football helmets by inclusion of faceguards during NOCSAE Standard drop tests. Additionally, two more impact locations are proposed to be added to the NOCSAE certification.

修改落塔冲击试验为美国橄榄球头盔

A modified National Operating Committee on Standards for Athletic Equipment (NOCSAE) test method for American football helmet drop impact test standards ...

生物工程

Revised and Neuroimaging-Compatible Versions of the Dual Task Screen

Dual task paradigms simultaneously assess motor and cognitive abilities, and they can detect subtle, residual impairments in athletes with recent mild traumatic brain injury (mTBI). However, past dual task paradigms have focused solely on lower extremity skills and have relied on cumbersome, expensive laboratory equipment - thus limiting their practicality for everyday mTBI evaluation. Subsequently, we developed the Dual Task Screen (DTS), which takes &#60;10 minutes to administer and score, uses low-cost portable equipment, and includes lower extremity (LE) and upper extremity (UE) subtasks. The purpose of this manuscript was twofold. First, we describe the administration protocol for the revised DTS, which we revised to address the limitations of the original DTS. Specifically, the revisions included additions of smart devices to acquire more detailed gait data and inclusion of single cognitive conditions to test for disrupted cognitive performance under dual task conditions. Importantly, the revised DTS is a measure intended for future clinical use, and we present representative results from three male athletes to illustrate the type of clinical data that can be acquired from the measure. Importantly, we have yet to evaluate the sensitivity and specificity of the revised DTS in athletes with mTBI, which is the next research initiative. The second purpose of this manuscript is to describe a neuroimaging-compatible version of the DTS. We developed this version so we could evaluate the neural underpinnings of single and dual task performance, for a better empirical understanding of the behavioral deficits associated with mTBI. Thus, this manuscript also describes the steps we took to enable simultaneous functional near-infrared spectroscopy (fNIRS) measurement during the DTS, along with how we acquired and completed first-level processing of the fNIRS data.

We developed the original Dual Task Screen (DTS) as a portable, low-cost measure that can evaluate athletes with sports-induced mild traumatic brain injury. We revised the original DTS for future clinical use and developed a neuroimaging-compatible version of the DTS to measure neural underpinnings of single and dual task performance.

双任务屏幕的修订和神经成像兼容版本

Dual task paradigms simultaneously assess motor and cognitive abilities, and they can detect subtle, residual impairments in athletes with recent mild ...

A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion

Concussion is one of the most commonly reported injuries amongst children and youth involved in sport participation. Following a concussion, youth can experience a range of short and long term neurobehavioral symptoms (somatic, cognitive and emotional/behavioral) that can have a significant impact on one&#8217;s participation in daily activities and pursuits of interest (e.g., school, sports, work, family/social life, etc.). Despite this, there remains a paucity in clinically driven research aimed specifically at exploring concussion within the youth sport population, and more specifically, multi-modal approaches to measuring recovery. This article provides an overview of a novel and multi-modal approach to measuring recovery amongst youth athletes following concussion. The presented approach involves the use of both pre-injury/baseline testing and post-injury/follow-up testing to assess performance across a wide variety of domains (post-concussion symptoms, cognition, balance, strength, agility/motor skills and resting state heart rate variability). The goal of this research is to gain a more objective and accurate understanding of recovery following concussion in youth athletes (ages 10-18 years). Findings from this research can help to inform the development and use of improved approaches to concussion management and rehabilitation specific to the youth sport community.

This article provides an overview of a multi-modal approach to assessing recovery following concussion in youth athletes. The described protocol uses pre- and post-concussion assessment of performance across a wide variety of domains and can inform the development of improved concussion rehabilitation protocols specific to the youth sport community.

多模式的方法来评估恢​​复的青少年运动员脑震荡之后

Concussion is one of the most commonly reported injuries amongst children and youth involved in sport participation. Following a concussion, youth can ...

A Neuroscientific Approach to the Examination of Concussions in Student-Athletes

Concussions are occurring at alarming rates in the United States and have become a serious public health concern. The CDC estimates that 1.6 to 3.8 million concussions occur in sports and recreational activities annually. Concussion as defined by the 2013 Concussion Consensus Statement &#8220;may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an &#8216;impulsive&#8217; force transmitted to the head.&#8221; Concussions leave the individual with both short- and long-term effects. The short-term effects of sport related concussions may include changes in playing ability, confusion, memory disturbance, the loss of consciousness, slowing of reaction time, loss of coordination, headaches, dizziness, vomiting, changes in sleep patterns and mood changes. These symptoms typically resolve in a matter of days. However, while some individuals recover from a single concussion rather quickly, many experience lingering effects that can last for weeks or months. The factors related to concussion susceptibility and the subsequent recovery times are not well known or understood at this time. Several factors have been suggested and they include the individual&#8217;s concussion history, the severity of the initial injury, history of migraines, history of learning disabilities, history of psychiatric comorbidities, and possibly, genetic factors. Many studies have individually investigated certain factors both the short-term and long-term effects of concussions, recovery time course, susceptibility and recovery. What has not been clearly established is an effective multifaceted approach to concussion evaluation that would yield valuable information related to the etiology, functional changes, and recovery. The purpose of this manuscript is to show one such multifaceted approached which examines concussions using computerized neurocognitive testing, event related potentials, somatosensory perceptual responses, balance assessment, gait assessment and genetic testing.

There is great variability in an individual&#8217;s risk for concussion and their corresponding recovery. A multifaceted approach to concussion evaluation is warranted; including baseline testing of athletes before participation in sport and timely evaluation post injury. The goal of this protocol is to provide an appropriate multifaceted approach to examine concussions.

一个神经科学方法脑震荡的学生运动员的考试

Concussions are occurring at alarming rates in the United States and have become a serious public health concern. The CDC estimates that 1.6 to 3.8 ...

Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion

The evidence-informed standardization of care along disease lines is recommended to improve outcomes and reduce healthcare costs. The aim of this project is to 1) describe the development and implementation of the Concussion Carepath, 2) demonstrate the process of integrating technology in the form of a mobile application to enable the carepath and guide clinical decision-making, and 3) present data on the utility of the C3 app in facilitating decision-making throughout the injury recovery process. A multi-disciplinary team of experts in concussion care was formed to develop an evidence-informed algorithm, outlining best practices for the clinical management of concussion along three phases of recovery &#8211; acute, subacute, and post-concussive. A custom mobile application, the Cleveland Clinic Concussion (C3) app was developed and validated to provide a platform for the systematic collection of objective, biomechanical outcomes and to provide guidance in clinical decision-making in the field and clinical environments. The Cleveland Clinic Concussion app included an electronic incident report, assessment modules to measure important aspects of cognitive and motor function, and a return to play module to systematically document the six phases of post-injury rehabilitation. The assessment modules served as qualifiers within the carepath algorithm, driving referral for specialty services as indicated. Overall, the carepath coupled with the C3 app functioned in unison to facilitate communication among the interdisciplinary team, prevent stagnant care, and drive patients to the right provider at the right time for efficient and effective clinical management.

A multidisciplinary carepath to standardize disparate concussion care was developed and implemented at the Cleveland Clinic. The Cleveland Clinic Concussion (C3) mobile application was used to enable the carepath through biomechanical outcomes characterizing cognitive and motor function. Patient outcomes improved while cost of care was reduced following implementation.

青少年及有脑震荡青少年多学科技术强化护理途径的开发与实施

The evidence-informed standardization of care along disease lines is recommended to improve outcomes and reduce healthcare costs. The aim of this project ...

Objectively Assessing Sports Concussion Utilizing Visual Evoked Potentials

A portable system capable of measuring steady-state visual-evoked potentials (SSVEP) was developed to provide an objective, quantifiable method of electroencephalogram (EEG) testing following a traumatic event. In this study, the portable system was used on 65 healthy rugby players throughout a season to determine whether SSVEP are a reliable electrophysiological biomarker for concussion. Preceding the competition season, all players underwent a baseline SSVEP assessment. During the season, players were re-tested within 72 h of a match for either test-retest reliability or post-injury assessment. In the case of a medically diagnosed concussion, players were reassessed again once deemed recovered by a physician. The SSVEP system consisted of a smartphone housed in a VR-frame delivering a 15 Hz flicker stimulus, while a wireless EEG headset recorded occipital activity. Players were instructed to stare at the screen's fixation point while remaining seated and quiet. Electrodes were arranged according to the 10-20 EEG-positioning nomenclature, with O1-O2 being the recording channels while P1-P2 the references and bias, respectively. All EEG data was processed using a Butterworth bandpass filter, Fourier transformation, and normalization to convert data for frequency analysis. Players SSVEP responses were quantified into a signal-to-noise ratio (SNR), with 15 Hz being the desired signal, and summarized into respective study groups for comparison. Concussed players were seen to have a significantly lower SNR compared to their baseline; however, post-recovery, their SNR was not significantly different from the baseline. Test-retest indicated high device reliability for the portable system. An improved portable SSVEP system was also validated against an established EEG amplifier to ensure the investigative design is capable of obtaining research quality EEG measurements. This is the first study to identify differences in SSVEP responses in amateur athletes following a concussion and indicates the potential for SSVEP as an aid in concussion assessment and management.

A portable system capable of measuring steady-state visual-evoked potentials was developed and trialed on 65 amateur rugby players over 18 weeks to investigate SSVEP as a potential electrophysiological biomarker for concussion. Players' baselines were measured pre-season, with retesting for reliability, concussion, and recovery assessment being conducted within controlled time-periods, respectively.

利用视觉诱发电位客观评估运动脑震荡

A portable system capable of measuring steady-state visual-evoked potentials (SSVEP) was developed to provide an objective, quantifiable method of ...

神经科学

Assessing Changes in Synaptic Plasticity Using an Awake Closed-Head Injury Model of Mild Traumatic Brain Injury

Mild traumatic brain injuries (mTBIs) are a prevalent health issue in North America. There is increasing pressure to utilize ecologically valid models of closed-head mTBI in the preclinical setting to increase translatability to the clinical population. The awake closed-headed injury (ACHI) model uses a modified controlled cortical impactor to deliver closed-headed injury, inducing clinically relevant behavioral deficits without the need for a craniotomy or the use of an anesthetic.
This technique does not normally induce fatalities, skull fractures, or brain bleeds, and is more consistent with being a mild injury. Indeed, the mild nature of the ACHI procedure makes it ideal for studies investigating repetitive mTBI (r-mTBI). Growing evidence indicates that r-mTBI can result in a cumulative injury that produces behavioral symptoms, neuropathological changes, and neurodegeneration. r-mTBI is common in youths playing sports, and these injuries occur during a period of robust synaptic reorganization and myelination, making the younger population particularly vulnerable to the long-term influences of r-mTBI.
Further, r-mTBI occurs in cases of intimate partner violence, a condition for which there are few objective screening measures. In these experiments, synaptic function was assessed in the hippocampus in juvenile rats that had experienced r-mTBI using the ACHI model. Following the injuries, a tissue slicer was utilized to make hippocampal slices to evaluate bidirectional synaptic plasticity in the hippocampus at either 1 or 7 days following the r-mTBI. Overall, the ACHI model provides researchers with an ecologically valid model to study changes in synaptic plasticity following mTBI and r-mTBI.

Here, it is demonstrated how an awake closed-head injury model can be used for examining the effects of repeated mild traumatic brain injury (r-mTBI) on synaptic plasticity in the hippocampus. The model replicates important features of r-mTBI in patients and is used in conjunction with in vitro electrophysiology.

使用轻度创伤性脑损伤的清醒闭合性头部损伤模型评估突触可塑性的变化

Mild traumatic brain injuries (mTBIs) are a prevalent health issue in North America. There is increasing pressure to utilize ecologically valid models of ...

视觉训练方法体育震荡缓解与管理

摘要

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此视频中的章节

在使用功能性磁共振成像和头部撞击遥测系统的青年与体育有关的震荡影响的调查

联合穿梭盒子训练与电的Cortex记录和刺激作为一种工具来研究感知和学习

控制下冲击头冲击的活体协议对现场研究数据的验证

修改落塔冲击试验为美国橄榄球头盔

双任务屏幕的修订和神经成像兼容版本

多模式的方法来评估恢复的青少年运动员脑震荡之后

一个神经科学方法脑震荡的学生运动员的考试

青少年及有脑震荡青少年多学科技术强化护理途径的开发与实施

利用视觉诱发电位客观评估运动脑震荡

使用轻度创伤性脑损伤的清醒闭合性头部损伤模型评估突触可塑性的变化

视觉训练方法体育震荡缓解与管理

摘要

探索更多视频

此视频中的章节

在使用功能性磁共振成像和头部撞击遥测系统的青年与体育有关的震荡影响的调查

联合穿梭盒子训练与电的Cortex记录和刺激作为一种工具来研究感知和学习

控制下冲击头冲击的活体协议对现场研究数据的验证

修改落塔冲击试验为美国橄榄球头盔

双任务屏幕的修订和神经成像兼容版本

多模式的方法来评估恢​​复的青少年运动员脑震荡之后

一个神经科学方法脑震荡的学生运动员的考试

青少年及有脑震荡青少年多学科技术强化护理途径的开发与实施

利用视觉诱发电位客观评估运动脑震荡

使用轻度创伤性脑损伤的清醒闭合性头部损伤模型评估突触可塑性的变化

多模式的方法来评估恢复的青少年运动员脑震荡之后