Brett Benjamin L, Kuhn Andrew W, Yengo-Kahn Aaron M, Kerr Zachary Y, Bonfield Christopher M, Solomon Gary S, Zuckerman Scott L
Department of Psychology, Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA.
Department Counseling, Educational Psychology and Research, University of Memphis, Memphis, TN, USA.
Sports Med Open. 2018 Jan 31;4(1):8. doi: 10.1186/s40798-018-0121-8.
Schedule-based and in-season factors (e.g., competition type) have been shown to be associated with symptom reporting patterns and injury severity in sport-related concussion (SRC). To determine if acute neurocognitive and symptom presentation following SRC differ by time point within a high school football season.
Multicenter ambispective cohort of high school football players who sustained a SRC (N = 2594). Timing (early, mid, and late season) of SRC was based on median dates for the start of the pre-season, regular season, and playoffs of each states' football schedules. Analysis of covariance (ANCOVA) investigated differences across season period groups for: (1) neurocognitive test scores, (2) total symptom scores (TSS), and (3) individual symptom increases from baseline within 1-week post-injury.
Significant group differences were observed in TSS, F(2, 2589) = 15.40, p < 0.001, η = 0.01, and individual symptom increases from baseline, F(2, 2591) = 16.40, p < 0.001, η = 0.01. Significant increases were seen from baseline to both midseason and late season in both TSS, χ = 24.40, p < 0.001, Φ = 0.10 and individual symptoms, χ = 10.32, p = 0.006, Φ = 0.10. Post hoc tests indicated a linear trend, with late-season injured athletes reporting approximately twice the TSS (13.10 vs. 6.77) and new symptoms (5.70 vs. 2.68) as those with early-season injuries.
In a cohort of American high school football student-athletes, those suffering SRC in the late-season time period had increased acute symptom burden. SRC sustained later in-season may require more conservative management.
基于赛程和赛季中的因素（如比赛类型）已被证明与运动性脑震荡（SRC）的症状报告模式和损伤严重程度相关。为了确定高中橄榄球赛季中SRC后急性神经认知和症状表现是否因时间点而异。
对2594名遭受SRC的高中橄榄球运动员进行多中心双向队列研究。SRC的时间（赛季早期、中期和晚期）基于每个州橄榄球赛程季前赛、常规赛和季后赛开始的中位数日期。协方差分析（ANCOVA）研究了不同赛季时间段组在以下方面的差异：（1）神经认知测试分数，（2）总症状评分（TSS），以及（3）受伤后1周内个体症状相对于基线的增加情况。
在TSS方面观察到显著的组间差异，F(2, 2589) = 15.40，p < 0.001，η = 0.01；在个体症状相对于基线的增加情况方面也观察到显著差异，F(2, 2591) = 16.40，p < 0.001，η = 0.01。从基线到赛季中期和晚期，TSS（χ = 24.40，p < 0.001，Φ = 0.10）和个体症状（χ = 10.32，p = 0.006，Φ = 0.10）均有显著增加。事后检验显示出线性趋势，赛季晚期受伤的运动员报告的TSS（13.10对6.77）和新症状（5.70对2.68）约为赛季早期受伤运动员的两倍。
在美国高中橄榄球学生运动员队列中，赛季晚期遭受SRC的运动员急性症状负担增加。赛季后期发生的SRC可能需要更保守的管理
