Evaluation of head kinematics experienced during common skill progression pathways in Women's Artistic Gymnastics.

This study aimed to evaluate head kinematics experienced during skill progression pathways in Women's Artistic Gymnastics to inform post-concussion return to gymnastics protocols. A return to gymnastics framework, consisting of seven skill progression pathways, was developed. Twelve gymnasts were instrumented with mouthpiece sensors and performed two trials of each skill, if able. Sensors recorded data at 100 Hz and skill segments were extracted using time-synchronised video. Peak resultant linear (PLA) and rotational acceleration (PRA), rotational velocity change index (ΔRV) and peak resultant rotational velocity (PRV) of 1 Hz low pass filtered data were computed from skills. A mixed effects model evaluated differences in kinematic metrics across skills within pathways while adjusting for random effects of the participant. Stepwise increases in kinematic metrics occurred along backward and forward tumbling (floor) pathways but did not occur in other pathways. For instance, gymnasts experienced greater PLA and PRV during clear hip and back hip circle compared to giant. Moreover, skills performed early along respective pathways (e.g, Yurchenko timer (to back), Tsukahara timer (to back), handstand forward roll) were among the skills with the greatest PRA and ΔRV. Head kinematics associated with skill performance should be considered when developing return to gymnastics protocols.