Resultant Effects of Head Impacts on Vestibular Function in Division I Male Lacrosse Players
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Context: Examination of the cumulative effects of number and magnitude of head impacts on the vestibular function among men’s lacrosse players. Objective: To determine the influence of total number of head impacts (THI) peak linear acceleration, Head Injury Criteria (HIC), and on vestibular function as assessed by vestibular ocular reflex (VOR) function over the course of one competitive season. Design: Pre-test/post- test design. Setting: Laboratory-based study. Patients or other Participants: 41 male lacrosse players, average age 20.6 ± 1.4 years, at an NCAA Division I university. Main Outcome Measures: VOR parameters as assessed by the inVision™ system to determine overall function and symmetry of the vestibular system included: maximum gaze velocity and percent of directional bias of the gaze stabilization test yaw; visual acuity difference and percent of directional bias of the dynamic visual acuity test for yaw and pitch head movements. Results: The total number (270.3 + 158.2) and magnitude of head impacts, as assessed by peak linear acceleration (50.9g + 158.2g) and HIC (33.9 + 38.3), were not significantly related to changes in vestibular function after one competitive, lacrosse season (R = 0.535, 0.201, 0.383, respectively, p > 0.05). Significant improvement was seen in DVA yaw from pre- to post-test (0.14 + 0.16 to 0.1 + 0.14; p = 0.048); however, no other significant changes were seen in VOR measures (p > 0.05). Self-reported incidence of concussion significantly predicted measures of greater vestibular asymmetry, specifically among participants who described previous medical histories of 3 or more concussions (R = 0.535; p = 0.036). Conclusion: The results of this study revealed that participant concussion history had the greatest influence on changes in VOR percent bias measures and vestibular asymmetry in collegiate male lacrosse players over the course of one competitive season. These findings support the inclusion of vestibular assessment and treatment in concussion management protocols to improve patient care and health related quality of life among lacrosse participants with previous medical histories of concussion.