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运动员脑震荡症状:损伤前因素预测损伤后因素。

Concussion Symptoms Among Athletes: Preinjury Factors Predict Postinjury Factors.

机构信息

Neuromuscular Research Laboratory, Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, Pennsylvania (Mr Sinnott); Department of Orthopaedic Surgery, UPMC Sports Medicine Concussion Program, University of Pittsburgh, Pittsburgh, Pennsylvania (Drs Kontos and Collins); and Kinesiology and Recreation Administration, Humboldt State University, Arcata, California (Dr Ortega).

出版信息

J Head Trauma Rehabil. 2020 Jul/Aug;35(4):E361-E371. doi: 10.1097/HTR.0000000000000562.

Abstract

OBJECTIVE

Determine whether preinjury concussion symptom factors predict postinjury concussion symptom factors.

SETTING

Community concussion surveillance program between 2008 and 2017.

PARTICIPANTS

A total of 290 high school and collegiate-aged athletes (n = 168, aged 14-17 years; n = 122, aged 18-21 years, respectively).

DESIGN

Retrospective analysis.

MAIN MEASURES

Post-Concussion Symptom Scale scores prior to and within 7 days of sustaining a sport-related concussion.

METHODS

Post-Concussion Symptom Scale scores were aggregated into cognitive-sensory, sleep-arousal, vestibular-somatic, and affective preinjury symptom factors. These preinjury symptom factors, in conjunction with sex and previous concussion history, underwent linear regressions to predict cognitive-migraine-fatigue, somatic, sleep, and affective postinjury symptom factors.

RESULTS

The cognitive-sensory factor (P = .002) and female sex (P = .002) predicted the postinjury cognitive-migraine-fatigue factor in combined age group but not stratified age group models. Among the 14 to 17 years age group, and not the 18 to 21 years age group, the preinjury sleep-arousal symptom factor predicted postinjury somatic (P = .003) and sleep factors (P = .005). The affective preinjury factor predicted the affective factor (P = .001) and somatic factor (P = .008) in the 18 to 21 years age group. A history of previous concussions also predicted the postinjury somatic symptom factor (P = .005).

CONCLUSION

Preinjury symptom factors predicted postinjury symptom factors and age-associated differences in symptom factors may provide clinical value in prognostic models for subsequent postinjury clinical outcomes.

摘要

目的

确定损伤前的脑震荡症状因素是否能预测损伤后的脑震荡症状因素。

设置

2008 年至 2017 年期间的社区脑震荡监测计划。

参与者

共有 290 名高中生和大学生运动员(n=168,年龄 14-17 岁;n=122,年龄 18-21 岁)。

设计

回顾性分析。

主要观察指标

发生与运动相关的脑震荡前和 7 天内的脑震荡后症状量表评分。

方法

脑震荡后症状量表评分被汇总为认知感觉、睡眠觉醒、前庭躯体和情感损伤前症状因素。这些损伤前症状因素,结合性别和既往脑震荡史,进行线性回归分析,以预测损伤后的认知偏头痛疲劳、躯体、睡眠和情感症状因素。

结果

认知感觉因素(P=0.002)和女性性别(P=0.002)预测了合并年龄组但未分层年龄组模型中的损伤后认知偏头痛疲劳因素。在 14 至 17 岁年龄组中,而不是在 18 至 21 岁年龄组中,损伤前的睡眠觉醒症状因素预测了损伤后的躯体(P=0.003)和睡眠因素(P=0.005)。情感损伤前因素预测了 18 至 21 岁年龄组的情感因素(P=0.001)和躯体因素(P=0.008)。既往脑震荡史也预测了损伤后的躯体症状因素(P=0.005)。

结论

损伤前的症状因素可以预测损伤后的症状因素,并且症状因素与年龄相关的差异可能为随后的损伤后临床结局的预后模型提供临床价值。

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