Dual task training may reduce risk of musculoskeletal injury caused by sensory & neuromuscular impairments after concussion (7/10/25 Newsletter)
This week, our lead article, Dual task training may reduce risk of musculoskeletal injury caused by sensory & neuromuscular impairments after concussion, is in the Therapies Currently Available category.
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In this newsletter: Opportunities, Concussion Alliance Lunch & Learn, Education, Therapies Currently Available, External Resource Highlight, & Youth
Writers: John Lin, Sofia Lozano, Anni Yurcisin, & Conor Gormally
Editors: Conor Gormally & Malayka Gormally
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Opportunities
Friday, July 11, 12 pm PST: A free webinar, Calm & Restore: At-Home Yoga Tools, with Jessica Shirley, Certified Health Education Specialist (CHES) and 200 Hour Registered Yoga Teacher (RYT). The program is hosted by Brain Northwest. Register in advance.
Monday, July 21, 12-2 pm EDT: A webinar, Minds Matter Concussion Model: Acute Clinical Concussion Management, "is open to anyone responsible for implementing a concussion protocol following injury," and all participants will receive an evaluation and treatment toolkit. Presenters include Christina L. Master, MD, who is considered one of the top clinician–researchers in this field. General admission (no continuing education credits) is $30. CEUs are available for ATs, Nurses, PTs, and Physicians; tickets range from $45 to $75.
Summer Concussion Alliance Lunch & Learn
July 24: Join Concussion Alliance Co-Founders for an Open Q&A!
On July 24th at 1 PM PST | 3 PM CST | 4 EST, join Concussion Alliance Co-Founders Conor Gormally & Malayka Gormally for our second virtual Lunch & Learn webinar! This Lunch & Learn will be an open Q&A with Conor and Malayka, so bring on your concussion questions! Note: We are unable to answer any personal questions about an individual’s specific medical issues, and these answers do not constitute medical advice.
Education
Using narrative tactics when delivering scientific information regarding concussion can improve its effectiveness
A recent study by Jesse Abdenour and Autumn Shafer in Health Communication examined the relationship between how concussion information is presented and the impact on an audience’s intended behaviors around concussion. This study involved presenting different kinds of videos to an audience of parents of youth athletes. They found that blending scientific and narrative style information delivery was most effective. As Shafer explains, “It’s important that you tell people a good story, use examples and explain the science behind it.”
The researchers conducted an online questionnaire experiment with parents of children aged 10-17, in which the parents reported their personal feelings and responses to content presented to them. Each parent was assigned to watch a single video. The parents were presented with one of three types of videos: a fully narrative-style video about personal experiences with concussions (either a teenage girl soccer player or a teenage boy football player), a scientific video about head trauma, and a combined video that included both narrative and scientific elements. After watching the videos, the audience self-reported on a 0-5 Likert scale, ranging from “Not at all” to “Extremely,” on how much their chosen video affected them in various ways. They reported on how much the video transported them into the content, including how authentic they believed the video was and how emotionally invested they felt. They also reported on how much they trusted the content of the video, their perception of the risk severity associated with concussion in the short and long term, their intent to make choices that would lower concussion risk for their child, and their likelihood of supporting sports concussion mitigation policies.
The study authors found that a combined style video was the most effective, increasing both trust and investment in the message presented and intent to mitigate concussion risk for their children in the future among the parents more than other video styles. Previously, there had been concern that adding a narrative to scientific information would dilute the scientific content or that scientific details could bog down a story; however, this study shows that weaving these two methods of sharing information together is the most effective approach.
Therapies Currently Available
Dual task training may reduce risk of musculoskeletal injury caused by sensory & neuromuscular impairments after concussion
A mini-review article published in Frontiers in Musculoskeletal Disorders explored research on the mechanisms underlying the increased risk of future musculoskeletal injuries after concussion and discussed neuromuscular exercise interventions to reduce these risks. Tyler A. Wood et al. noted that concussions impact the vestibular, visual, and other sensory systems of the body, leading to hindrances to coordination and gait, as well as difficult-to-detect neuromuscular adaptations (including changes in proprioception and postural control). These sensory and neuromuscular changes increase the risk of musculoskeletal injuries. In turn, musculoskeletal injuries may alter the body's mechanics, limiting dexterity and mobility and promoting wear and tear of cartilage in the joints––all factors that increase the risk of osteoarthritis and potential long-term disability.
For example, in one of the studies referenced by Tyler A. Wood et al., Buckley and colleagues studied 102 college athletes, 66 of whom sustained a concussion during the study. Those who had sustained a concussion were 1.78 times more likely to have a lower extremity musculoskeletal injury within 12 months of their concussion. Kardouni and colleagues studied 23,044 military members, 11,522 of whom had sustained a concussion. Participants with a concussion were 1.45 times more likely to sustain a lower extremity musculoskeletal injury within 15 months of their concussion. Concussion may disrupt or alter the "central nervous system's neural pathways responsible for coordinating muscle activity," leading to "abnormal muscle firing sequences, reduced muscle strength, and compensatory movement strategies." Lynall and colleagues concluded that individuals who had a history of concussion had a higher risk of osteoarthritis––even individuals who did not sustain a musculoskeletal injury post-concussion.
The results from these studies address a correlation between neuromuscular and neurodegenerative alterations after a concussion. The authors suggest several currently available testing methods that are more effective than the mBESS and tandem gait in assessing neuromuscular alterations. However, more research is needed to develop clinical tests that combine physical and cognitive factors to properly assess neuromuscular adaptations. In terms of interventions, the authors recommend incorporating dual-task training, in which patients perform motor and cognitive tasks simultaneously.
"challenges both motor and cognitive systems and may help with cognitive-motor integration to reduce concussion-related neuromuscular adaptations." Additionally, the authors note that more research is needed to develop "evidence-based rehabilitation interventions to improve neuromuscular adaptations following concussion," including exercises that focus on "restoring motor control and coordination." These strategies could create a framework to best prevent neuromuscular adaptations and support post-concussion recovery.
Youth
Traumatic head injury from child maltreatment: Recognizing red flags in clinical practice
Traumatic head injury due to child maltreatment (THI-CM) is a serious and potentially fatal form of abuse, particularly in infants and young children. A journal article, Medical Assessment of Suspected THI-CM, "provides health care providers with guidance for identifying and medically assessing suspected THI-CM in infants and children." Author Michelle Shouldice et al. emphasize that these injuries can be difficult to detect and require clinicians to remain alert to subtle signs and symptoms, as well as inconsistencies in caregivers' reports.
One important point in the article, published in Paediatric and Child Health, notes that while subdural hemorrhage (SDH) can occur at birth, "Trauma is the most common cause" of subdural hemorrhage (SDH). Therefore, when "there is no clear accidental traumatic explanation, the most common cause" of SDH is child maltreatment. The healthcare provider should check for red flags in three domains: patient history, clinical presentation, and radiographic (imaging) findings. When taking the patient's history, for example, providers should consider whether a reported injury event is inconsistent with the child's developmental abilities. The article also lists clinical presentations and radiographic findings that should raise a strong suspicion of abuse. The authors stress that no single injury confirms abuse; instead, diagnosis must be based on a combination of patient history, clinical presentation, and imaging findings.
The article advocates for a systematic and multidisciplinary approach that incorporates pediatrics, radiology, ophthalmology, and child protection services to ensure accurate identification and intervention. The authors emphasize, “Clinicians must report concerns of child maltreatment to appropriate authorities and ensure that recommended medical evaluations in suspected THI-CM cases are completed.”
The guidelines are especially relevant for young children who cannot describe their symptoms, making clinical judgment and standardized tools essential. As noted in a related Medscape article, Dr. Lori Frasier explains, "The goal is not to turn every ER doctor into a child abuse expert, but to give them enough tools to pause and consider whether an injury fits the story being told." These findings have significant implications: early recognition of suspicious injuries and standardized evaluation processes can improve child safety, reduce misdiagnosis, and provide critical support to those with THI-CM.
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