Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA.
Sports Medicine Center, Children's Hospital Colorado, Aurora, CO, USA.
J Child Neurol. 2020 Jun;35(7):456-462. doi: 10.1177/0883073820909046. Epub 2020 Mar 19.
Our objective was to examine the effect of current neck or shoulder pain on concussion outcomes. Variables included symptom resolution and return-to-sport time, symptom severity, amount of school missed, and sleep disturbances. Three hundred twelve patients (37% female; median age = 15.0 years; evaluated median = 9 days postinjury) reported experiencing current neck or shoulder pain at initial evaluation, and 268 did not (31% female; median age = 14.7 years; evaluated median = 8 days postinjury). Neck or shoulder pain was associated with longer symptom resolution time (β = 6.38, 95% confidence interval [CI] = 2.44, 10.31; = .002), more severe symptoms (β = 7.06, 95% CI = 4.91, 9.21; < .001), and greater odds of missing >5 days of school (adjusted odds ratio [aOR] = 1.89, 95% CI = 1.23, 2.93; = .004), and postinjury sleep problems (aOR = 2.20, 95% CI = 1.51, 3.21; < .001). Experiencing neck or shoulder pain during the initial postinjury clinical evaluation was associated with worsened clinical outcomes. Clinicians may consider referral to early rehabilitation following concussion among those who report neck or shoulder pain.
我们的目的是研究当前颈部或肩部疼痛对脑震荡结果的影响。变量包括症状缓解和重返运动时间、症状严重程度、缺课天数和睡眠障碍。312 名患者（37%为女性；中位年龄=15.0 岁；评估中位数=受伤后 9 天）在初次评估时报告有当前颈部或肩部疼痛，而 268 名患者没有（31%为女性；中位年龄=14.7 岁；评估中位数=受伤后 8 天）。颈部或肩部疼痛与症状缓解时间延长相关（β=6.38，95%置信区间[CI]为 2.44-10.31；=.002）、症状更严重（β=7.06，95% CI = 4.91-9.21；<.001）以及缺课>5 天的几率更高（校正比值比[aOR] = 1.89，95% CI = 1.23-2.93；=.004），以及受伤后睡眠问题（aOR = 2.20，95% CI = 1.51-3.21；<.001）。在初次受伤后的临床评估中经历颈部或肩部疼痛与更差的临床结果相关。对于报告颈部或肩部疼痛的患者，临床医生可能会考虑在脑震荡后早期转介至康复治疗。
