Revant Rehabilitation Centre, Breda, the Netherlands (Drs Renaud, van de Port, and Lambregts); Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, the Netherlands (Drs Renaud and van Heugten); Limburg Brain Injury Center, Maastricht, the Netherlands (Drs Renaud and van Heugten); Departments of Paediatric Neurology (Dr Catsman-Berrevoets) and Rehabilitation Medicine (Dr Lambregts), Erasmus University Hospital/Sophia Children's Hospital, Rotterdam, the Netherlands; Department of Neurology, Haaglanden Medical Centre, the Hague, the Netherlands (Dr Jellema); and School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands (Dr van Heugten).
J Head Trauma Rehabil. 2020 Nov/Dec;35(6):E501-E512. doi: 10.1097/HTR.0000000000000584.
To investigate the natural course of activities and participation of children up to 6 months after a mild traumatic brain injury (mTBI).
A prospective longitudinal cohort study with complete data sets of 231 children diagnosed with mTBI and their caregivers.
Activities and participation assessed with the Child and Adolescent Scale of Participation (CASP) and the Children's Assessment of Participation and Enjoyment (CAPE) measured at 2 weeks, 3 months, and 6 months post-mTBI. Because of a ceiling effect, the primary outcome measure (CASP) was divided into deviant (not maximum score) or full functioning.
Friedman's, Cochran's Q, and McNemar's tests (CASP) and repeated-measures analyses of variance (CAPE) showed significant increases in activities and participation between 2 weeks and 3 and 6 months after mTBI. Based on the parents' perspective, 67% of the children returned to full functioning at 6 months postinjury, with only 38% of the children describing themselves as functioning at their premorbid level.
Findings indicate that most children return to maximum level of activities and participation over time after mTBI. In a substantial number of children, however, the level of activities and participation at 6 months postinjury is evaluated as lower than that of peers. The importance of investigating predictors for child and caregiver perspectives is emphasized.
研究轻度创伤性脑损伤（mTBI）后儿童在 6 个月内的活动和参与的自然病程。
这是一项前瞻性纵向队列研究，纳入了 231 名确诊为 mTBI 的儿童及其照顾者，所有数据完整。
使用儿童和青少年参与量表（CASP）和儿童参与和享受评估（CAPE）评估 mTBI 后 2 周、3 个月和 6 个月时的活动和参与情况。由于存在上限效应，主要结局测量指标（CASP）分为功能异常（未达到最高评分）或功能正常。
弗里德曼、柯克兰 Q 和麦克内马尔检验（CASP）和重复测量方差分析（CAPE）显示，mTBI 后 2 周、3 个月和 6 个月时，活动和参与均显著增加。基于家长的观点，67%的儿童在受伤后 6 个月时恢复到正常功能，只有 38%的儿童描述自己的功能恢复到了发病前的水平。
研究结果表明，大多数 mTBI 儿童在受伤后会随着时间的推移逐渐恢复到最高水平的活动和参与。然而，在相当数量的儿童中，受伤后 6 个月的活动和参与水平被评估为低于同龄人的水平。强调了研究儿童和照顾者观点的预测因素的重要性。
