School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, 4072, Australia.
School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, 4072, Australia; Physiotherapy Department, The Royal Brisbane and Women's Hospital, Herston, Australia.
Musculoskelet Sci Pract. 2019 Jun;41:15-22. doi: 10.1016/j.msksp.2019.02.002. Epub 2019 Feb 20.
To further explore symptoms in patients beyond the expected recovery period post mild Traumatic Brain Injury (mTBI) that are potentially indicative of impairment.
Ninety-four individuals (62 diagnosed with mTBI within the previous 4-24 weeks and 32 healthy controls) participated in the study. Participants in the mTBI group were further grouped as symptomatic (n = 33) or asymptomatic (n = 29) based on their spontaneous report of symptoms at the time of screening. Measures included a demographic questionnaire, 8 impairment specific self-report clinical tools, and a standard post-mTBI self-report symptom scale (Head Injury Scale (HIS)).
Compared to the control group, scores for all instruments (including the HIS) were higher in the symptomatic mTBI group (P < 0.05), and higher for the neck disability and hyperarousal measures in the asymptomatic mTBI group (p < 0.035), but not the HIS (p > 0.093). Overall 94% of the symptomatic and 62% of the asymptomatic participants post-mTBI, recorded scores considered to be clinically relevant on at least one impairment screening tool. In contrast, only 28% of the asymptomatic mTBI group recorded a clinically relevant score for the HIS.
Symptoms indicative of persisting impairments beyond the expected recovery period were apparent in a substantial proportion of individuals post mTBI. Furthermore, a high percentage of individuals initially reporting as symptom free demonstrated clinically relevant scores on at least one impairment screening tool. Findings also suggest that a standard post-mTBI self-report symptom scale may often not detect the presence of persisting symptoms.
进一步探讨轻度创伤性脑损伤（mTBI）后预期恢复期之外的患者症状，这些症状可能表明存在损伤。
94 名参与者（62 名在过去 4-24 周内被诊断为 mTBI，32 名健康对照）参加了这项研究。mTBI 组的参与者根据筛查时的自发报告症状进一步分为有症状组（n=33）或无症状组（n=29）。测量包括人口统计学问卷、8 种损伤特异性自我报告临床工具和标准的 post-mTBI 自我报告症状量表（头部损伤量表（HIS））。
与对照组相比，有症状 mTBI 组的所有工具（包括 HIS）评分均较高（P<0.05），无症状 mTBI 组的颈部残疾和过度唤醒测量评分也较高（p<0.035），但 HIS 评分则没有（p>0.093）。总体而言，94%的 post-mTBI 有症状和 62%的无症状参与者记录了至少一种损伤筛查工具上认为具有临床意义的分数。相比之下，只有 28%的无症状 mTBI 组记录了 HIS 上具有临床意义的分数。
在相当一部分 mTBI 后个体中，出现了表明持续存在损伤的症状，这些症状超出了预期的恢复期。此外，有很大比例的最初报告无症状的个体在至少一种损伤筛查工具上记录了具有临床意义的分数。研究结果还表明，标准的 post-mTBI 自我报告症状量表可能常常无法检测到持续存在的症状。
