NeuroTrauma Research Laboratory, University of Michigan, Ann Arbor.
United States Air Force Academy, CO.
J Athl Train. 2020 Jul 1;55(7):658-665. doi: 10.4085/1062-6050-10-19.
Assessments of the duration of concussion recovery have primarily been limited to sport-related concussions and male contact sports. Furthermore, whereas durations of symptoms and return-to-activity (RTA) protocols encompass total recovery, the trajectory of each duration has not been examined separately.
To identify individual (eg, demographics, medical history), initial concussion injury (eg, symptoms), and external (eg, site) factors associated with symptom duration and RTA-protocol duration after concussion.
Cohort study.
Three US military service academies.
A total of 10 604 cadets at participating US military service academies enrolled in the study and completed a baseline evaluation and up to 5 postinjury evaluations. A total of 726 cadets (451 men, 275 women) sustained concussions during the study period.
MAIN OUTCOME MEASURE(S): Number of days from injury (1) until the participant became asymptomatic and (2) to complete the RTA protocol.
Varsity athlete cadets took less time than nonvarsity cadets to become asymptomatic (hazard ratio [HR] = 1.75, 95% confidence interval = 1.38, 2.23). Cadets who reported less symptom severity on the Sport Concussion Assessment Tool, third edition (SCAT3), within 48 hours of concussion had 1.45 to 3.77 times shorter symptom-recovery durations than those with more symptom severity. Similar to symptom duration, varsity status was associated with a shorter RTA-protocol duration (HR = 1.74, 95% confidence interval = 1.34, 2.25), and less symptom severity on the SCAT3 was associated with a shorter RTA-protocol duration (HR range = 1.31 to 1.47). The academy that the cadet attended was associated with the RTA-protocol duration (P < .05).
The initial total number of symptoms reported and varsity athlete status were strongly associated with symptom and RTA-protocol durations. These findings suggested that external (varsity status and academy) and injury (symptom burden) factors influenced the time until RTA.
对脑震荡恢复时间的评估主要局限于与运动相关的脑震荡和男性接触性运动。此外，虽然症状和重返活动（RTA）方案的持续时间涵盖了总恢复期，但每个持续时间的轨迹尚未分别进行检查。
确定与脑震荡后症状持续时间和 RTA 方案持续时间相关的个体（例如，人口统计学、病史）、初始脑震荡损伤（例如，症状）和外部（例如，地点）因素。
队列研究。
美国三所军事学院。
参加研究的三所美国军事学院共有 10604 名学员，完成了基线评估和多达 5 次伤后评估。在研究期间，共有 726 名学员（451 名男性，275 名女性）发生脑震荡。
（1）从损伤到参与者无症状的天数，（2）完成 RTA 方案的天数。
与非校队学员相比，校队学员从受伤到无症状的时间更短（危险比[HR] = 1.75，95%置信区间= 1.38，2.23）。在脑震荡后 48 小时内，报告在运动性脑震荡评估工具第 3 版（SCAT3）上症状严重程度较低的学员，其症状恢复时间比症状严重程度较高的学员短 1.45 至 3.77 倍。与症状持续时间相似，校队状态与 RTA 方案持续时间较短相关（HR = 1.74，95%置信区间= 1.34，2.25），SCAT3 上症状严重程度较低与 RTA 方案持续时间较短相关（HR 范围= 1.31 至 1.47）。学员所在的学院与 RTA 方案持续时间相关（P <.05）。
最初报告的症状总数和校队运动员状态与症状和 RTA 方案持续时间密切相关。这些发现表明，外部（校队状态和学院）和损伤（症状负担）因素影响 RTA 时间。
