The Effects of External Jugular Compression Applied during High Intensity Power, Strength and Postural Control Tasks

Abstract

Introduction Current strategies focused on mitigating concussion in sport have demonstrated limited effectiveness. There is a paucity of research on the optimization of intracranial brain dynamics to mitigate concussion; in the present study, we investigate a novel device that provides mild jugular vein compression and may provide adjunctive protection to protect the brain internally from concussive and sub-concussive impacts. The purpose of this study was to assess the tolerance and acceptance of this device in a population of normal, healthy adults undergoing exertion similar to that is experienced while participating in sports-related competition, while monitoring changes in their biomechanical, strength, power, and postural stability capabilities.

Material and Methods A total 18 participants (8 females, 10 males) were tested and included in the final analysis. Laboratory data collection consisted of two separate testing sessions for all participants. During the first testing session, participants were tested while wearing either the mild jugular vein compression neck device or a sham arm device (Sham) that was worn on the upper arm and did not alter venous return; participants exchanged devices for the second session. Participants underwent a battery of physical and neurological tests that included three-dimensional (3-D) biomechanical analysis, dynamic postural control testing using a stabilometer, isokinetic strength testing using a dynamometer, and a maximum vertical jump test.

Results Evaluation of vital biomechanics, postural control and dynamic stabilization, isokinetic strength, and power in this population showed no statistically significant effect of wearing a mild jugular vein compression neck device compared with a Sham armband.

Conclusions The data evaluated in the current project indicate that the device is safe during high intensity and dynamic postural stabilization exercise and does not alter normal physical or neuromuscular capabilities during physical activity.

Keywords

concussion - jugular vein - biomechanics

• References

• 1 Smith DW, Bailes JE, Fisher JA, Robles J, Turner RC, Mills JD. Internal jugular vein compression mitigates traumatic axonal injury in a rat model by reducing the intracranial slosh effect. Neurosurgery 2012; 70 (03) 740-746
• 2 Smith DW, Myer GD, Currie DW, Comstock RD, Clark JF, Bailes JE. Altitude modulates concussion incidence: implications for optimizing brain compliance to prevent brain injury in athletes. Orthop J Sports Med 2013; 1 (06) 2325967113511588
• 3 Myer GD, Yuan W, Barber Foss KD. , et al. The effects of external jugular compression applied during head impact exposure on longitudinal changes in brain neuroanatomical and neurophysiological biomarkers: a preliminary investigation. Front Neurol 2016; 7: 74
• 4 Myer GD, Yuan W, Barber Foss KD. , et al. Analysis of head impact exposure and brain microstructure response in a season-long application of a jugular vein compression collar: a prospective, neuroimaging investigation in American football. Br J Sports Med 2016; 50 (20) 1276-1285
• 5 Hatt A, Cheng S, Tan K, Sinkus R, Bilston LE. MR elastography can be used to measure brain stiffness changes as a result of altered cranial venous drainage during jugular compression. AJNR Am J Neuroradiol 2015; 36 (10) 1971-1977
• 6 Hewett TE, Myer GD, Ford KR. , et al. Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. Am J Sports Med 2005; 33 (04) 492-501
• 7 Ford KR, Myer GD, Hewett TE. Valgus knee motion during landing in high school female and male basketball players. Med Sci Sports Exerc 2003; 35 (10) 1745-1750
• 8 Myer GD, Ford KR, Hewett TE. Rationale and clinical techniques for anterior cruciate ligament injury prevention among female athletes. J Athl Train 2004; 39 (04) 352-364
• 9 Ruedl G, Webhofer M, Helle K. , et al. Leg dominance is a risk factor for noncontact anterior cruciate ligament injuries in female recreational skiers. Am J Sports Med 2012; 40 (06) 1269-1273
• 10 Paterno MV, Schmitt LC, Ford KR. , et al. Biomechanical measures during landing and postural stability predict second anterior cruciate ligament injury after anterior cruciate ligament reconstruction and return to sport. Am J Sports Med 2010; 38 (10) 1968-1978
• 11 Myer GD, Ford KR, Barber Foss KD, Liu C, Nick TG, Hewett TE. The relationship of hamstrings and quadriceps strength to anterior cruciate ligament injury in female athletes. Clin J Sport Med 2009; 19 (01) 3-8
• 12 Plisky PJ, Rauh MJ, Kaminski TW, Underwood FB. Star Excursion Balance Test as a predictor of lower extremity injury in high school basketball players. J Orthop Sports Phys Ther 2006; 36 (12) 911-919
• 13 Zazulak BT, Hewett TE, Reeves NP, Goldberg B, Cholewicki J. The effects of core proprioception on knee injury: a prospective biomechanical-epidemiological study. Am J Sports Med 2007; 35 (03) 368-373
• 14 Hewett TE, Torg JS, Boden BP. Video analysis of trunk and knee motion during non-contact anterior cruciate ligament injury in female athletes: lateral trunk and knee abduction motion are combined components of the injury mechanism. Br J Sports Med 2009; 43 (06) 417-422