1Department of Psychology,Veterans Affairs Connecticut Healthcare System,West Haven,Connecticut.
3Vanderbilt Sports Concussion Center,Vanderbilt University School of Medicine,Nashville,Tennessee.
J Int Neuropsychol Soc. 2018 May;24(5):476-485. doi: 10.1017/S1355617717001321. Epub 2018 Jan 8.
This study investigated the relationship between on-field, objective signs immediately following sport-related concussion and self-reported symptom endorsement within 1 day post injury.
A retrospective case series of 237 concussed high school athletes was performed. On-field signs were evaluated immediately post injury. Self-reported symptoms (2 clusters) were collected within 1 day post injury. A two-step structural equation model and follow-up bivariate regression analyses of significant on-field signs and symptom clusters were performed.
Signs of immediate memory, β=0.20, p=.04, and postural instability, β=0.19, p < .01, significantly predicted a greater likelihood of endorsing the cognitive-migraine-fatigue symptom cluster within 1 day post injury. Regarding signs correlated with specific symptoms, immediate memory was associated with symptoms of trouble remembering, χ 2 =37.92, p < .001, odds ratio (OR)=3.89 (95% confidence interval (CI) [2.47, 6.13]), and concentration difficulties, χ 2 =10.84, p=.001, OR=2.13 (95% CI [1.37, 3.30]). Postural instability was associated with symptom endorsement of trouble remembering, χ 2 =12.08, p < .001, OR=1.76 (95% CI [1.29, 2.40]).
Certain post-concussion on-field signs exhibited after injury were associated with specific symptom endorsement within 1 day post injury. Based on these associations, individualized education-based interventions and academic accommodations may help reduce unanticipated worry from parents, students, and teachers following a student-athlete's sport-related concussion, especially in cases of delayed onset symptoms. (JINS, 2018, 24, 476-485).
本研究旨在探讨运动相关性脑震荡后即刻的现场客观体征与伤后 1 天内自我报告的症状之间的关系。
对 237 例患有运动相关性脑震荡的高中生进行了回顾性病例系列研究。在受伤后即刻评估现场体征。伤后 1 天内收集自我报告的症状（2 个簇）。进行了两步结构方程模型和对有意义的现场体征和症状簇的后续双变量回归分析。
即刻记忆障碍和姿势不稳的体征，β=0.20，p=.04 和β=0.19，p <.01，显著预测了在伤后 1 天内更有可能出现认知-偏头痛-疲劳症状簇。关于与特定症状相关的体征，即刻记忆与记忆障碍、χ 2 =37.92，p <.001，比值比（OR）=3.89（95%置信区间（CI）[2.47，6.13]）和注意力集中困难，χ 2 =10.84，p=.001，OR=2.13（95% CI [1.37，3.30]）有关。姿势不稳与记忆障碍的症状有关，χ 2 =12.08，p <.001，OR=1.76（95% CI [1.29，2.40]）。
受伤后出现的某些脑震荡后现场体征与伤后 1 天内的特定症状有关。基于这些关联，个性化的以教育为基础的干预措施和学术适应可能有助于减少学生运动员运动相关性脑震荡后家长、学生和教师的意外担忧，尤其是在出现延迟发病症状的情况下。（JINS，2018，24，476-485）。
