Department of Exercise and Sport Science, 209 Fetzer, CB#8700, University of North Carolina, Chapel Hill, NC 27599-8700, USA.
PM R. 2011 Apr;3(4):353-64; quiz 364. doi: 10.1016/j.pmrj.2010.12.006.
This article aims to examine pediatric concussion literature with respect to epidemiology, etiology, return to play, and recurrent concussions, and to provide recommendations for future research. We conducted a review of pediatric concussion literature regarding incidence, etiology, return to play, and recurrent concussive injury by using MEDLINE, CINAHL, Sport-Discus, and PsychInfo databases from 1995-2010. A review of reference lists in the aforementioned articles was also performed. We discovered that the research on sports-related concussion specific to children and adolescents is rather limited. Results of existing studies of concussion incidence in this population indicate that concussion is relatively rare compared with most musculoskeletal injuries; however, the potential consequences of mismanagement and of subsequent injury warrant significant attention regarding injury recognition and recovery, and the challenge of determining readiness to return to play. Evidence exists that children and adolescents take longer to recover than adults after a concussion, which underscores the need for a more conservative approach to management and return to physical and cognitive activities. Concussion in the young athlete is of specific concern because of the continuing cognitive maturation, therefore, the recovery may be more difficult to track when using the standard assessment tools currently available. Until future studies can better delineate the mechanisms of, response to, and recovery from concussion in the young athlete, it is prudent to act in a conservative manner when dealing with pediatric athletes with concussion.
本文旨在研究儿科脑震荡文献，探讨其流行病学、病因、重返赛场以及复发性脑震荡等问题，并为未来研究提供建议。我们检索了 1995 年至 2010 年 MEDLINE、CINAHL、Sport-Discus 和 PsychInfo 数据库中有关儿科脑震荡发病率、病因、重返赛场和复发性脑震荡损伤的文献，还对上述文章的参考文献进行了回顾。研究发现，专门针对儿童和青少年的运动相关性脑震荡研究相当有限。现有研究结果表明，与大多数肌肉骨骼损伤相比，脑震荡在该人群中相对较少见；然而，管理不当和随后受伤的潜在后果需要引起人们对损伤识别和康复的高度重视，以及确定重返赛场准备程度的挑战。有证据表明，儿童和青少年在脑震荡后比成年人恢复得更慢，这突显出在管理和重返身体和认知活动方面需要采取更为保守的方法。由于年轻运动员认知仍在不断成熟，因此，在使用目前可用的标准评估工具时，可能更难以追踪其恢复情况，因此年轻运动员的脑震荡更值得关注。在未来的研究能够更好地阐明年轻运动员脑震荡的机制、反应和恢复情况之前，在处理患有脑震荡的儿科运动员时，谨慎行事是明智的。
