Holmes Acacia, Chen Zhongxue, Yahng Lilian, Fletcher David, Kawata Keisuke
Department of Kinesiology, School of Public Health-Bloomington, Indiana University, Bloomington, IN, United States.
Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington, IN, United States.
Front Pediatr. 2020 Mar 4;8:57. doi: 10.3389/fped.2020.00057. eCollection 2020.
While awareness and understanding of concussion have improved drastically, post-concussion management in academic settings is still at its infancy. The aim of the study was to examine to what extent concussion influences academic performance and to whether there would be a difference in concussion effects on academic performance between high school and college students. This cross-sectional survey study included students, who were between 14 and 24 years old and sustained a sport-related concussion within the previous year. The study used a modified chain-referral sampling method, by distributing a questionnaire link to 3,000 randomly stratified athletic trainers, who worked in high school or college settings. These athletic trainers were then asked to forward the questionnaire link to students in their team, who have sustained a concussion within the previous year. The questionnaire recorded responses regarding demographics (age, sex, race/ethnicity, number of previous concussions); 22 concussion-related symptoms in a binary scale (presence/absence); perception of difficulties in math, reading, writing, computer use, and attention in a 5-point Likert scale; and asymptomatic duration of academic engagement in a 7-point Likert scale. There were 130 respondents with a history of concussion in the past year ( = 59 high school, = 71 college). While recovering from concussion, significantly more college students (84.5%) reported "difficulty concentrating" than high school students (68.6%: = 0.049). High -school students experienced more difficulty with math than college students ( = 0.002), whereas college students experienced more difficulty with reading ( = 0.013) and computer use ( = 0.026) than high school students. Asymptomatic duration of cognitive activity was influenced by age ( = 0.0004), where younger students were less tolerant in performing academic tasks after a concussion than older students. Our data indicate that concussions can induce negative symptoms in the academic setting regardless of age. The post-concussion difficulties in academic performance may be a grade-dependent manner, where concussions triggered difficulty in math among high school students and in reading and computer use among college students. It is clear that there is a need for guidelines and accommodations to support students with concussion in academic settings, and the guideline should reflect the age-dependent response to concussions.
虽然人们对脑震荡的认识和理解有了大幅提高，但学术环境中的脑震荡后管理仍处于起步阶段。本研究的目的是调查脑震荡在多大程度上影响学业成绩，以及高中生和大学生在脑震荡对学业成绩的影响方面是否存在差异。这项横断面调查研究纳入了年龄在14至24岁之间、且在前一年遭受过与运动相关脑震荡的学生。该研究采用了改良的链式推荐抽样方法，向3000名随机分层的、在高中或大学工作的体育教练分发问卷链接。然后要求这些体育教练将问卷链接转发给他们团队中在前一年遭受过脑震荡的学生。问卷记录了有关人口统计学特征（年龄、性别、种族/民族、既往脑震荡次数）的回答；以二元量表（存在/不存在）记录的22种与脑震荡相关的症状；以5分量表记录的在数学、阅读、写作、计算机使用和注意力方面的困难感知；以及以7分量表记录的学业参与的无症状持续时间。共有130名在过去一年有脑震荡史的受访者（高中生59名，大学生71名）。在从脑震荡中恢复的过程中，报告“注意力难以集中”的大学生（84.5%）明显多于高中生（68.6%：P = 0.049）。高中生在数学方面比大学生遇到更多困难（P = 0.002），而大学生在阅读（P = 0.013）和计算机使用（P = 0.026）方面比高中生遇到更多困难。认知活动的无症状持续时间受年龄影响（P = 0.0004），即较年轻的学生在脑震荡后进行学术任务时比年长的学生耐受性更低。我们的数据表明，无论年龄大小，脑震荡都可能在学术环境中引发负面症状。脑震荡后学业成绩方面的困难可能与年级有关，脑震荡会使高中生在数学方面出现困难，而使大学生在阅读和计算机使用方面出现困难。显然，需要有指导方针和便利措施来支持学术环境中患有脑震荡的学生，并且该指导方针应反映出对脑震荡的年龄依赖性反应。
