Concussion Clinical Trial
Official title:
Safety Testing of an Innovative Concussion Prevention Device
Significant morbidity, mortality, and related costs are caused by traumatic brain injury (TBI). A simple, effective, and lightweight device worn by athletes or war fighters in the field, designed to mitigate TBI resulting from blast trauma or concussive events, would save lives, and the huge costs currently being experienced for life-treatment of surviving victims. An externally-worn medical device that applies mild jugular compression according to the principle of the Queckenstedt Maneuver. PURPOSE: To monitor changes in vital signs, blood physiologies, oxygen consumption, biomechanics, strength, neurological capabilities, and balance in a population of athletes wearing the Device. Secondly, to determine the tolerance and acceptance of the Device while undergoing exertion.
The Device has the promise of providing a novel mechanism for reducing or preventing the
likelihood of TBI, and may be used in conjunction with other protective equipment. TBI is
the leading cause of death in individuals under age 45. The cost of TBI in the U.S. is
estimated at anywhere from $50 to $150 billion, annually. The January, 2008 New England
Journal of Medicine reports, "Head and neck injuries, including severe brain trauma, have
been reported in one quarter of service members who have been evacuated from Iraq and
Afghanistan"[1-3]. The vast majority of these injuries have resulted from exposure to
improvised explosive device (IED) blast waves. Head injuries, concussions and the resulting
trauma have been in public discussion recently as the National Football League (NFL) deals
with a lawsuit regarding head injuries by about one-third of living former NFL players and
are also a concern for athletes who participate in a wide range of sports, including hockey,
rugby and soccer.
According to NASA, "The oscillation of a fluid caused by external force, called sloshing,
occurs in moving vehicles containing liquid masses, such as trucks, etc." This oscillation
occurs when a vessel is only partially filled. Similarly, the brain faces slosh peril during
external force impartation. Slosh permits external energies to be absorbed by the contents
of a partially filled vessel or container by means of inelastic collisions. Tissues of
differing densities can decelerate at different rates creating shear and cavitation. If the
collisions between objects or molecules are elastic, the transfer of energies to those
objects diminishes, minimizing the energies imparted by slosh.
Woodpeckers, head ramming sheep and all mammals (including mankind) have small, little known
and misunderstood muscles in their necks called the omo-hyoid muscles. Highly G-tolerant
creatures of the forest have utilized these muscles to gently restrict outflow of the
internal jugular veins thereby "taking up" the excess compliance of the cranial space and
ultimately protecting themselves from TBI like tiny "airbags" in a motor vehicle.
This study utilizes a randomized cross over study design. Subjects will visit the Human
Performance Laboratory on two separate occasions to perform the testing procedures listed in
the table below. During one testing session, the subject will perform the testing procedures
while wearing the Device under investigation while the other testing session will be
completed while the subject is wearing a sham arm device, which will be placed on the upper
arm and not cause venous engorgement. The order of the testing sessions will be randomized
prior to the subject's arrival for the first session. The Device is a standard hockey neck
guard, adapted for the purposes of this study. The Device incorporates two bulges localized
over the site of the internal jugular veins bilaterally. Experiments performed with jugular
Doppler ultrasound demonstrate that while wearing the Device, flows within the jugular veins
are reduced, while flow within the carotid arteries and all portions of the cerebrum are
preserved (JA Fisher, unpublished data). Thus, application of the Device to the subject will
not cause any untoward health risks. The pressure exerted by the Device on the region of the
neck superficial to the internal jugular vein is akin to the pressure felt when a person
yawns or wears a snugly fitting necktie.
;
Allocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Crossover Assignment, Masking: Open Label
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