Cervical Muscle Activation and Strain Responses in Helmeted Individuals during Post-Concussion Head Injury Rehabilitation
DOI:
https://doi.org/10.63282/3050-9416.IJAIBDCMS-V6I4P131Keywords:
Cervical Spine, Concussion, Muscle Activation, Surface EMG, Helmet Biomechanics, Strain Sensors, Rehabilitation, Mixed MethodsAbstract
Post-concussion rehabilitation increasingly emphasizes neuromuscular control of the cervical spine, particularly in athletic and military populations where helmet use often continues during recovery. The cervical musculature is essential for head stabilization, proprioceptive input, and attenuation of mechanical loads following mild traumatic brain injury (mTBI). However, helmets alter head mass distribution and inertial properties, potentially influencing cervical muscle activation and spinal strain during rehabilitation tasks. Despite widespread helmet use, limited research has examined its biomechanical implications in post-concussion rehabilitation settings. This study investigates cervical muscle activation and biomechanical strain responses in helmeted individuals undergoing post-concussion rehabilitation using a mixed-methods approach. Thirty athletes (aged 18–35) with medically diagnosed concussions within the previous six months completed standardized head movements and dynamic stabilization exercises under helmeted and non-helmeted conditions. Quantitative data were collected using surface electromyography (sEMG) to assess muscle activation and strain sensors to measure cervical loading. Additionally, semi-structured interviews with six rehabilitation specialists provided qualitative insights into observed movement strategies and fatigue patterns. Results demonstrated significantly increased sEMG activity in the sternocleidomastoid and upper trapezius muscles during helmeted dynamic stabilization tasks (p < 0.01). Cervical strain analysis revealed elevated shear forces at the C3–C5 spinal levels when helmets were worn. Clinicians consistently reported altered motor control strategies, earlier onset of fatigue, and increased muscular compensation under helmeted conditions. These findings indicate that helmet use meaningfully modifies cervical neuromuscular activation and strain during post-concussion rehabilitation. Incorporating helmet-related biomechanical considerations into rehabilitation planning may improve recovery outcomes and inform safer return-to-play or return-to-duty protocols.
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