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未受伤和脑震荡青少年运动员在脑震荡平衡测试(COBALT)上的比较。

Comparison of Uninjured and Concussed Adolecent Athletes on the Concussion Balance Test (COBALT).

机构信息

Banner University Sports Medicine and Concussion Specialists, Phoenix, Arizona (S.M., A.A., S.E., E.M., H.K., B.S., S.S., B.N., J.P.); and Banner University Medical Center Phoenix, Phoenix, Arizona (R.G.).

出版信息

J Neurol Phys Ther. 2018 Jul;42(3):149-154. doi: 10.1097/NPT.0000000000000225.

Abstract

BACKGROUND AND PURPOSE

Dizziness and balance problems are common symptoms following sports-related concussion (SRC). Most sports require high-level balance skills that integrate the sensory inputs used for balance. Thus, a comprehensive assessment of postural control following SRC is recommended as an integral part of evaluation and management of the injury. The purpose of this exploratory study was to examine performance differences between uninjured and concussed athletes on the Concussion Balance Test (COBALT), as well as complete preliminary analyses of criterion-related validity and reliability of COBALT.

METHODS

COBALT is an 8 condition test developed for both preseason and postinjury assessment using force plate technology to measure sway velocity under dynamic postural conditions that challenge the vestibular system. Retrospective COBALT data obtained through chart review for 132 uninjured athletes and 106 concussed age-matched athletes were compared.

RESULTS

All uninjured athletes were able to complete the assessment, compared with only 55% of concussed athletes. Concussed athletes committed significantly more errors than uninjured athletes. Sway velocity for concussed athletes was higher (worse) than that for uninjured athletes on 2 conditions in COBALT.

DISCUSSION AND CONCLUSIONS

By examining an athlete's ability to complete the protocol, error rate, and sway velocity on COBALT postinjury, the clinician can identify balance function impairment, which may help the medical team develop a more targeted treatment plan, and provide objective input regarding recovery of balance function following SRC.Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A204).

摘要

背景与目的

头晕和平衡问题是运动相关性脑震荡(SRC)后的常见症状。大多数运动都需要高水平的平衡技能,这些技能整合了用于平衡的感觉输入。因此,建议对 SRC 后的姿势控制进行全面评估,作为损伤评估和管理的一个组成部分。本探索性研究的目的是检查未受伤和脑震荡运动员在脑震荡平衡测试(COBALT)上的表现差异,以及 COBALT 的初步效标关联效度和可靠性分析。

方法

COBALT 是一种 8 种条件的测试,使用测力板技术为运动员进行赛前和伤后评估,以测量在动态姿势条件下的摆动速度,这些条件挑战了前庭系统。通过对 132 名未受伤运动员和 106 名年龄匹配的脑震荡运动员的图表回顾获得的 COBALT 回顾性数据进行了比较。

结果

所有未受伤的运动员都能够完成评估,而只有 55%的脑震荡运动员能够完成。脑震荡运动员比未受伤运动员犯的错误明显更多。在 COBALT 的 2 种情况下,脑震荡运动员的摆动速度更高(更差)。

讨论和结论

通过检查运动员在受伤后完成方案、错误率和 COBALT 上的摆动速度的能力,临床医生可以识别平衡功能障碍,这可能有助于医疗团队制定更有针对性的治疗计划,并提供关于 SRC 后平衡功能恢复的客观信息。视频摘要可从作者处获得更多见解(见补充数字内容 1,可在 http://links.lww.com/JNPT/A204 获得)。

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