简单台阶测试与青少年脑震荡后运动准备的关系。
Association of Simple Step Test With Readiness for Exercise in Youth After Concussion.
机构信息
Sydney Children's Hospital Network, Children's Hospital Institute of Sports Medicine, The Royal Alexandra Hospital for Children, Children's Hospital Westmead, Sydney, Australia (Messrs Fyffe and Browne and Ms Bogg); Discipline of Exercise and Sport Science, Faculty of Health Sciences, The University of Sydney, and The Children's Hospital at Westmead Clinical School, Sydney Medical School, The University of Sydney, Australia (Dr Orr); and Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Australia (Prof Browne).
出版信息
J Head Trauma Rehabil. 2020 Mar/Apr;35(2):E95-E102. doi: 10.1097/HTR.0000000000000512.
OBJECTIVES
We hypothesized that a submaximal step test would be associated with readiness to commence graded exercise in children and adolescents with concussion.
METHODS
Children and adolescents aged 8 to 18 years performed standard concussion clinical assessment for vestibular/ocular and balance impairment, and exercise examination utilizing the 3-minute Kasch Pulse Recovery test (KPR) and a symptom-limited graded exercise test (GXT). Outcome measures included activity readiness and symptom exacerbation.
RESULTS
Forty-five participants (mean age 13.2 ± 2.1 years, 76% male) had a confirmed concussion (73% sports-related). Some participants required follow-up testing giving 75 clinical presentations. Sensitivity and specificity of the KPR were 100% and 95.7%, respectively. Area under the receiver operating characteristics curve was 0.979. Activity readiness to GXT and KPR was strongly associated (χ = 21.672, P < .001), while symptom exacerbation showed a significant correlation between testing methods (r = 0.796, P < .001). Better exercise performance on GXT and KPR was significantly correlated with normal Vestibular/Ocular Motor Screening (rs = -0.380, P = .010, and rs = -0.281, P = .017, respectively) and Modified Balance Error Scoring System (rs = -0.452, P < .001, and rs = -0.301, P = .010, respectively).
CONCLUSION
The KPR is a simple and practical tool to determine whether it is appropriate for a child or adolescent with concussion to commence graded exercise.
目的
我们假设亚极量台阶测试与儿童和青少年脑震荡后开始分级运动的准备情况相关。
方法
8 至 18 岁的儿童和青少年进行了标准的脑震荡临床评估，包括前庭/眼动和平衡障碍，以及使用 3 分钟卡斯脉搏恢复测试（KPR）和症状限制分级运动测试（GXT）进行的运动检查。结果测量包括活动准备情况和症状恶化情况。
结果
45 名参与者（平均年龄 13.2 ± 2.1 岁，76%为男性）确诊为脑震荡（73%与运动有关）。一些参与者需要进行随访测试，共进行了 75 次临床检查。KPR 的灵敏度和特异性分别为 100%和 95.7%。受试者工作特征曲线下的面积为 0.979。GXT 和 KPR 的活动准备情况与测试方法密切相关（χ=21.672，P<.001），而症状恶化情况在两种测试方法之间也存在显著相关性（r=0.796，P<.001）。GXT 和 KPR 上更好的运动表现与正常的前庭/眼动筛查（rs=-0.380，P=0.010 和 rs=-0.281，P=0.017）和改良平衡错误评分系统（rs=-0.452，P<.001 和 rs=-0.301，P=0.010）显著相关。
结论
KPR 是一种简单实用的工具，可以确定儿童或青少年脑震荡后是否适合开始分级运动。
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