{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T15:11:04Z","timestamp":1790176264118,"version":"4.1.0"},"reference-count":40,"publisher":"International Journal of Sports Physical Therapy","issue":"3","license":[{"start":{"date-parts":[[2024,3,2]],"date-time":"2024-03-02T00:00:00Z","timestamp":1709337600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"\n Background<\/jats:title>\n Fatigue is common in sports, impairing performance and increasing injury risk, yet little is known regarding fatigue and concussion. Impaired neck neuromuscular function may contribute to concussion at baseline, where central fatigue may further impair neck function resulting in increased concussion risk. These effects may be magnified in athletes with a history of concussion.<\/jats:p>\n <\/jats:sec>\n \n Purpose<\/jats:title>\n To determine the effect of exercise induced central fatigue on neck joint position error, strength, and endurance in healthy subjects and those with a history of concussion. The investigators hypothesized that EICF would have a negative effect on all variables.<\/jats:p>\n <\/jats:sec>\n \n Study Design<\/jats:title>\n Healthy subjects were examined using a single factor, within-subjects repeated measures design. Concussion history subjects were examined using a single-subject design.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Nineteen healthy subjects and five subjects with a history of concussion were recruited for the study. Cervical joint position error, muscle strength, and neck flexor endurance were tested before and after exercise induced fatigue.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n There was a significant increase in constant (p = 0.0027) and absolute joint position error (JPE) (p < 0.001); decrease in neck flexor endurance (p < 0.001); and decrease neck strength into cervical flexion (p = 0.01) in healthy subjects following fatigue. Among concussion history subjects, five demonstrated a significant increase in absolute and constant JPE (p < 0.05); four demonstrated a significant decrease in neck flexor endurance (p < 0.05); one in neck flexion muscle strength (p < 0.05); and three in neck extension and rotation muscle strength (p < 0.05) following fatigue.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Cervical neuromuscular function deteriorated following fatigue in healthy subjects. Resulting impairments may affect force alterations in cervical control, potentially increasing concussion risk. Concussion history subjects descriptively demonstrated similar results, however further research should examine formal comparisons involving subjects with and without concussion history.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n 3b<\/jats:p>\n <\/jats:sec>","DOI":"10.26603\/001c.92703","type":"journal-article","created":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T08:08:35Z","timestamp":1709280515000},"source":"Crossref","is-referenced-by-count":2,"title":["The Effect of Exercise-Induced Central Fatigue on Cervical Spine Joint Position Error, Strength, and Endurance"],"prefix":"10.26603","volume":"19","author":[{"given":"Antonio","family":"Vintimilla","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/033ztpr93","id-type":"ROR","asserted-by":"publisher"}],"name":"Texas Tech University Health Sciences Center","department":["Rehabilitation Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Troy","family":"Hooper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Roger","family":"James","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho Cheng","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karthick","family":"Natesan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeegisha","family":"Kapila","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phil","family":"Sizer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"11140","published-online":{"date-parts":[[2024,3,2]]},"reference":[{"issue":"1","key":"ref1","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1186\/1743-0003-3-22","article-title":"The effects of moderate fatigue on dynamic balance control and attentional demands","volume":"3","author":"Martin Simoneau","year":"2006","journal-title":"Journal of NeuroEngineering and Rehabilitation","ISSN":"https:\/\/id.crossref.org\/issn\/1743-0003","issn-type":"print"},{"issue":"12","key":"ref2","doi-asserted-by":"publisher","first-page":"2294","DOI":"10.1113\/ep088186","article-title":"Endurance exercise-induced and mental fatigue and the brain","volume":"106","author":"Romain Meeusen","year":"2021","journal-title":"Experimental Physiology","ISSN":"https:\/\/id.crossref.org\/issn\/0958-0670","issn-type":"print"},{"issue":"12","key":"ref3","doi-asserted-by":"publisher","first-page":"510","DOI":"10.3390\/jcm7120510","article-title":"The effect of mental fatigue on cognitive and aerobic performance in adolescent active endurance athletes: Insights from a randomized counterbalanced, cross-over trial","volume":"7","author":"Maamer Slimani","year":"2018","journal-title":"Journal of Clinical Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/2077-0383","issn-type":"print"},{"issue":"15","key":"ref4","doi-asserted-by":"publisher","first-page":"5608","DOI":"10.3390\/ijerph17155608","article-title":"Acute effects of ACL injury-prevention warm-up and soccer-specific fatigue protocol on dynamic knee valgus in youth male soccer players","volume":"17","author":"Marco Andr\u00e9s Garc\u00eda-Luna","year":"2020","journal-title":"International Journal of Environmental Research and Public Health","ISSN":"https:\/\/id.crossref.org\/issn\/1660-4601","issn-type":"print"},{"issue":"6","key":"ref5","first-page":"768","article-title":"Evaluating the effects of match-induced fatigue on landing ability; the case of the basketball game","volume":"14","author":"N Liveris","year":"2021","journal-title":"Int J Exerc Sci"},{"issue":"5","key":"ref6","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1097\/jsm.0000000000000276","article-title":"Incidence and factors associated with concussion injuries at the 2011 to 2014 South African rugbyunion youth week tournaments","volume":"26","author":"Sarah Mc Fie","year":"2016","journal-title":"Clinical Journal of Sport Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/1050-642X","issn-type":"print"},{"issue":"11","key":"ref7","doi-asserted-by":"publisher","first-page":"2325967117740862","DOI":"10.1177\/2325967117740862","article-title":"Game schedules and rate of concussions in the National Football League","volume":"5","author":"Masaru Teramoto","year":"2017","journal-title":"Orthopaedic Journal of Sports Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/2325-9671","issn-type":"print"},{"issue":"1","key":"ref8","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1080\/15438620701879020","article-title":"In-game fatigue influences concussions in National Hockey League players","volume":"16","author":"Sean T. 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