Dougan Brooke K, Horswill Mark S, Geffen Gina M
School of Psychology, The University of Queensland, Brisbane, Queensland, Australia.
J Int Neuropsychol Soc. 2014 Jan;20(1):64-80. doi: 10.1017/S1355617712001464. Epub 2013 Feb 4.
The objective of this study is to determine which pre-existing athlete characteristics, if any, are associated with greater deficits in functioning following sports-related concussion, after controlling for factors previously shown to moderate this effect (e.g., time since injury). Ninety-one independent samples of concussion were included in a fixed+systematic effects meta-analysis (n = 3,801 concussed athletes; 5,631 controls). Moderating variables were assessed using analogue-to-ANOVA and meta-regression analyses. Post-injury assessments first conducted 1-10 days following sports-related concussion revealed significant neuropsychological dysfunction, postural instability and post-concussion symptom reporting (d = -0.54, -1.10, and -1.14, respectively). During this interval, females (d = -0.87), adolescent athletes competing in high school competitions (d = -0.60), and those with 10 years of education (d = -1.32) demonstrated larger post-concussion neuropsychological deficits than males (d = -0.42), adults (d = -0.25), athletes competing at other levels of competition (d = -0.43 to -0.41), or those with 16 years of education (d = -0.15), respectively. However, these sub-groups' differential impairment/recovery beyond 10 days could not be reliably quantified from available literature. Pre-existing athlete characteristics, particularly age, sex and education, were demonstrated to be significant modifiers of neuropsychological outcomes within 10 days of a sports-related concussion. Implications for return-to-play decision-making and future research directions are discussed.
本研究的目的是确定在控制先前已证明可调节这种效应的因素（例如受伤后的时间）之后，哪些先前存在的运动员特征（如果有的话）与运动相关脑震荡后功能的更大缺陷相关。91个独立的脑震荡样本被纳入固定效应+系统效应荟萃分析（n = 3801名脑震荡运动员；5631名对照）。使用类似方差分析和荟萃回归分析评估调节变量。在与运动相关的脑震荡后1至10天首次进行的伤后评估显示出明显的神经心理功能障碍、姿势不稳和脑震荡后症状报告（效应量分别为-0.54、-1.10和-1.14）。在此期间，女性（效应量=-0.87）、参加高中比赛的青少年运动员（效应量=-0.60）和受教育年限为10年的运动员（效应量=-1.32）表现出比男性（效应量=-0.42）、成年人（效应量=-0.25）、参加其他比赛水平的运动员（效应量=-0.43至-0.41）或受教育年限为16年的运动员（效应量=-0.15）更大的脑震荡后神经心理缺陷。然而，从现有文献中无法可靠地量化这些亚组在10天后的差异损伤/恢复情况。先前存在的运动员特征，特别是年龄、性别和教育程度，被证明是运动相关脑震荡后10天内神经心理结果的重要调节因素。文中讨论了对重返比赛决策的影响以及未来的研究方向。
