Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO; Department of Rehabilitation Medicine, Children's Hospital Colorado, Aurora, CO.
Department of Rehabilitation Medicine, Children's Hospital Colorado, Aurora, CO.
J Pediatr. 2020 May;220:207-213.e2. doi: 10.1016/j.jpeds.2020.01.068. Epub 2020 Mar 5.
To prospectively evaluate symptom outcomes after youth soccer-related concussion.
Using a prospective cohort design, we enrolled male and female competitive soccer players age 8-17 years into 3 groups: concussed (n = 23), matched control (n = 23), and orthopedic injury (n = 24). Postconcussive symptoms were monitored serially via both athlete and parent report at days 1-2, 4, 7, 10, 30, and 90.
Repeated-measures analyses revealed a significant time by group interaction (F [12, 402] = 19.91, P < .001). In the initial days postinjury, the concussed group reported greater symptoms than the comparison groups, with more symptoms reported by athletes on average than parents. By 10 days, concussed athletes did not differ from the matched controls by either rater's report, but they did differ from the orthopedic injury group by parent report. At 30 days, no differences were apparent among groups. At 30 days, 100% of concussed youth and 91% of parents rated symptoms as back to preinjury levels using reliable change indices. At 30 days, 86% of athletes had been cleared to return to full game play.
The natural clinical history of concussion symptoms in youth competitive soccer players was similar to that seen in older athletes, with resolution in days to a few weeks. Additional study will be required to investigate which factors best predict symptom outcomes for individual athletes and how symptom report relates to performance-based outcome measures and underlying neurophysiologic recovery.
前瞻性评估与青年足球相关的脑震荡后症状结局。
使用前瞻性队列设计，我们将 8-17 岁的男性和女性竞技足球运动员纳入 3 组：脑震荡组（n=23）、匹配对照组（n=23）和骨科损伤组（n=24）。通过运动员和家长报告，在第 1-2、4、7、10、30 和 90 天连续监测脑震荡后症状。
重复测量分析显示时间与组间存在显著交互作用（F[12, 402]=19.91，P<.001）。在受伤后的最初几天，脑震荡组报告的症状比对照组更严重，运动员报告的平均症状比家长更多。到第 10 天，运动员报告的脑震荡组与匹配对照组无差异，但家长报告的脑震荡组与骨科损伤组有差异。30 天时，各组之间无明显差异。30 天时，100%的脑震荡青少年和 91%的家长使用可靠变化指数评定症状恢复到受伤前水平。30 天时，86%的运动员已获准恢复全面比赛。
青年竞技足球运动员脑震荡后症状的自然临床病程与老年运动员相似，在几天至几周内恢复。需要进一步研究哪些因素能最好地预测个别运动员的症状结局，以及症状报告与基于表现的结局测量和潜在神经生理恢复的关系。
