Gardner Andrew J, Wojtowicz Magdalena, Terry Douglas P, Levi Christopher R, Zafonte Ross, Iverson Grant L
a Hunter New England Sports Concussion Program, John Hunter Hospital; Centre for Stroke and Brain Injury, School of Medicine and Public Health , University of Newcastle , Callaghan , NSW , Australia.
b Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital , MassGeneral Hospital for Children™ Sport Concussion Program, & Home Base, A Red Sox Foundation and Massachusetts General Hospital Program , Boston , Massachusetts , USA.
Brain Inj. 2017;31(13-14):1918-1924. doi: 10.1080/02699052.2017.1358399. Epub 2017 Sep 5.
This study reviewed the available sideline Sport Concussion Assessment Tool-Third Edition (SCAT3) performance of players who were removed from play using the 'concussion interchange rule' (CIR), the available video footage of these incidences, and associated return to play and concussion diagnosis decisions.
Descriptive, observational case series.
Data were collected from all NRL players who used the CIR during the 2014 season.
Complete SCAT3 and video analysis data were available for 38 (23%) of 167 uses of the concussion interchange rule, of which 20 (52.6%) players were medically diagnosed with concussion. Those with video evidence of unresponsiveness performed more poorly on the modified Balance Error Scoring System (M-BESS; p = .04; Cohen's d = .69) and reported greater symptoms (p = .03; d = .51). Similarly, players with a vacant stare reported greater symptoms (p = .05; d = .78). Those who demonstrated three signs (unresponsiveness, vacant stare and gait ataxia) performed more poorly on the M-BESS (p = .03; d = 1.4) and reported greater symptoms than those with no observable signs (p = .03; d = 1.4).
The SCAT3 is sensitive to the acute effects of concussion in professional athletes; however, a minority of injured athletes might go undetected by this test.
本研究回顾了使用“脑震荡替换规则”（CIR）被换下场的球员的场边运动性脑震荡评估工具第三版（SCAT3）的可用表现、这些事件的可用视频片段以及相关的重返赛场和脑震荡诊断决定。
描述性观察性病例系列。
收集了2014赛季所有使用CIR的国家橄榄球联盟（NRL）球员的数据。
在167次脑震荡替换规则使用中，有38次（23%）获得了完整的SCAT3和视频分析数据，其中20名（52.6%）球员被医学诊断为脑震荡。有反应迟钝视频证据的球员在改良平衡误差评分系统（M-BESS）上表现更差（p = 0.04；科恩d值 = 0.69），且报告的症状更严重（p = 0.03；d值 = 0.51）。同样，眼神空洞的球员报告的症状更严重（p = 0.05；d值 = 0.78）。表现出三种体征（反应迟钝、眼神空洞和步态共济失调）的球员在M-BESS上表现更差（p = 0.03；d值 = 1.4），且报告的症状比没有明显体征的球员更严重（p = 0.03；d值 = 1.4）。
SCAT3对职业运动员脑震荡的急性影响敏感；然而，少数受伤运动员可能无法通过该测试被检测出来。
