Nelson Lindsay D, Guskiewicz Kevin M, Barr William B, Hammeke Thomas A, Randolph Christopher, Ahn Kwang Woo, Wang Yanzhi, McCrea Michael A
Medical College of Wisconsin, Milwaukee;
University of North Carolina at Chapel Hill;
J Athl Train. 2016 Feb;51(2):142-52. doi: 10.4085/1062-6050-51.4.04. Epub 2016 Mar 14.
Younger age has been hypothesized to be a risk factor for prolonged recovery after sport-related concussion, yet few studies have directly evaluated age differences in acute recovery.
To compare clinical recovery patterns for high school and collegiate athletes.
Prospective cohort study.
Large, multicenter prospective sample collected from 1999-2003 in a sports medicine setting.
Concussed athletes (n = 621; 545 males and 76 females) and uninjured controls (n = 150) participating in high school and collegiate contact and collision sports (79% in football, 15.7% in soccer, and the remainder in lacrosse or ice hockey).
MAIN OUTCOME MEASURE(S): Participants underwent evaluation of symptoms (Graded Symptom Checklist), cognition (Standardized Assessment of Concussion, paper-and-pencil neuropsychological tests), and postural stability (Balance Error Scoring System). Athletes were evaluated preinjury and followed serially at several time points after concussive injury: immediately, 3 hours postinjury, and at days 1, 2, 3, 5, 7, and 45 or 90 (with neuropsychological measures administered at baseline and 3 postinjury time points).
Comparisons of concussed high school and collegiate athletes with uninjured controls suggested that high school athletes took 1 to 2 days longer to recover on a cognitive (Standardized Assessment of Concussion) measure. Comparisons with the control group on other measures (symptoms, balance) as well as direct comparisons between concussed high school and collegiate samples revealed no differences in the recovery courses between the high school and collegiate groups on any measure. Group-level recovery occurred at or before 7 days postinjury on all assessment metrics.
The findings suggest no clinically significant age differences exist in recovery after sport-related concussion, and therefore, separate injury-management protocols are not needed for high school and collegiate athletes.
有假说认为年龄较小是与运动相关脑震荡后恢复时间延长的一个风险因素，但很少有研究直接评估急性恢复过程中的年龄差异。
比较高中和大学运动员的临床恢复模式。
前瞻性队列研究。
1999年至2003年在运动医学环境中收集的大型多中心前瞻性样本。
参加高中和大学接触性和碰撞性运动的脑震荡运动员（n = 621；545名男性和76名女性）以及未受伤的对照组（n = 150）（79%为橄榄球运动员，15.7%为足球运动员，其余为长曲棍球或冰球运动员）。
参与者接受症状评估（症状分级清单）、认知评估（脑震荡标准化评估、纸笔神经心理测试）和姿势稳定性评估（平衡误差评分系统）。运动员在受伤前接受评估，并在脑震荡损伤后的几个时间点进行连续随访：受伤后立即、3小时、第1天、第2天、第3天、第5天、第7天以及第45天或第90天（神经心理测试在基线和受伤后3个时间点进行）。
脑震荡的高中和大学运动员与未受伤对照组的比较表明，高中运动员在认知（脑震荡标准化评估）指标上恢复时间要长1至2天。在其他指标（症状、平衡）上与对照组的比较以及脑震荡的高中和大学样本之间的直接比较显示，高中和大学组在任何指标的恢复过程中均无差异。所有评估指标在受伤后7天或之前均出现组水平的恢复。
研究结果表明，与运动相关脑震荡后的恢复不存在临床上显著的年龄差异，因此，高中和大学运动员不需要单独的损伤管理方案。
