Gibson Sarah, Nigrovic Lise E, O'Brien Michael, Meehan William P
Meli Orthopedics, Ft. Lauderdale, FL, USA.
Brain Inj. 2013;27(7-8):839-42. doi: 10.3109/02699052.2013.775494. Epub 2013 Jun 12.
To determine whether recommending cognitive rest to athletes after a sport-related concussion affects time to symptom resolution.
A retrospective cohort study was conducted of 184 patients who presented to a sports concussion clinic in an academic medical centre between 1 November 2007 and 31 July 2009. The effect of recommending cognitive rest on symptom duration (days) was measured after adjusting for age, gender, initial PCSS score, history of amnesia, history of loss of consciousness and number of previous concussions. Using multivariate logistic regression, independent predictors of prolonged symptoms were identified, defined as >30 days.
Of the 135 study patients with complete medical records, 85 (63%) had cognitive rest recommended. Of those, 79 (59%) had prolonged symptoms. In the multivariate analysis, only initial PCSS score was associated with the duration of concussion symptoms (adjusted odds ratio (AOR) = 1.03; 95% CI = 1.01-1.05). The recommendation for cognitive rest was not significantly associated with time to concussion symptom resolution (AOR = 0.5; 95% CI = 0.18-1.37).
Given the limited evidence regarding the effects of cognitive rest on recovery from concussion, recommendations of prolonged periods of cognitive rest, particularly absences from school, should be approached cautiously.
确定在与运动相关的脑震荡后向运动员推荐认知休息是否会影响症状缓解时间。
对2007年11月1日至2009年7月31日期间在一所学术医疗中心的运动脑震荡诊所就诊的184例患者进行了一项回顾性队列研究。在调整年龄、性别、初始PCSS评分、失忆史、意识丧失史和既往脑震荡次数后，测量推荐认知休息对症状持续时间（天）的影响。使用多变量逻辑回归，确定症状延长（定义为>30天）的独立预测因素。
在135例有完整病历的研究患者中，85例（63%）被推荐进行认知休息。其中，79例（59%）症状延长。在多变量分析中，只有初始PCSS评分与脑震荡症状持续时间相关（调整后的优势比（AOR）=1.03；95%置信区间（CI）=1.01-1.05）。推荐认知休息与脑震荡症状缓解时间无显著相关性（AOR=0.5；95%CI=0.18-1.37）。
鉴于关于认知休息对脑震荡恢复影响的证据有限，对于长时间认知休息的建议，尤其是缺课的建议，应谨慎对待。
