J Orthop Sports Phys Ther. 2019 Nov;49(11):855-863. doi: 10.2519/jospt.2019.8918. Epub 2019 Oct 9.
Pediatric and adolescent concussion is an increasingly high-profile public health issue, but it is also a highly heterogeneous phenomenon. Many factors interact dynamically to influence the recovery trajectory of adolescents and children. Diagnostic assessment must include domains other than self-reported symptoms, yet many prognostic models of outcome focus solely on the presence or absence of postconcussion symptoms to determine recovery. Function after concussion (recovery or persistence of problems) is the result of an interaction between biological, psychological, and social factors. Despite biopsychosocial models of assessment being advocated in rehabilitation for the last 20 years, they are still not routinely implemented in the evaluation of concussions, along the recovery trajectory, in children and adolescents. The International Classification of Functioning, Disability and Health is a framework anchored in a biopsychosocial perspective that can guide clinicians and researchers to include multiple perspectives in their assessments or research designs. By focusing on the patient as a person, researchers and clinicians can provide a more holistic approach that has the potential to contribute to a more successful and sustainable pediatric and adolescent concussion care model. .
儿科和青少年脑震荡是一个日益受到关注的公共卫生问题，但也是一个高度异质的现象。许多因素相互作用，动态地影响青少年和儿童的恢复轨迹。诊断评估必须包括自我报告症状以外的其他领域，但许多预后模型仅关注脑震荡后症状的存在与否来确定恢复情况。脑震荡后的功能（恢复或问题持续存在）是生物、心理和社会因素相互作用的结果。尽管在过去 20 年中，康复领域提倡采用生物心理社会评估模型，但在儿童和青少年的脑震荡评估中，仍未沿恢复轨迹常规实施这些模型。《国际功能、残疾和健康分类》是一个基于生物心理社会观点的框架，可以指导临床医生和研究人员在评估或研究设计中纳入多个视角。通过关注患者作为一个人，研究人员和临床医生可以提供更全面的方法，有可能为更成功和可持续的儿科和青少年脑震荡护理模式做出贡献。
