From the Ohio State University College of Medicine (J.B.C.), Columbus; University of Florida (Z.H., J.R.C.), Gainesville; University of Delaware (T.W.K., K.N.B., T.A.B.), Newark; Harvard Medical School (G.L.I.), Boston; Spaulding Rehabilitation Hospital and Spaulding Research Institute (G.L.I.), Charlestown; MassGeneral Hospital for Children (G.L.I.), Boston; Home Base (G.L.I.), A Red Sox Foundation and Massachusetts General Hospital Program, Boston; The Micheli Center for Sports Injury Prevention (J.R.O.), Boston Children's Hospital, Waltham, MA; Uniformed Services University of the Health Sciences (P.F.P.), Bethesda; Walter Reed National Military Medical Center (P.F.P.), Bethesda, MD; University of Michigan (S.P.B.), Ann Arbor; Indiana University School of Medicine (T.W.M.), Indianapolis; Medical College of Wisconsin (M.M.), Milwaukee; Azusa Pacific University (A.M.H.), CA; Bloomsburg University (J.B.H.), PA; California Lutheran University (L.A.K.), Thousand Oaks; Humboldt State University (J.D.O.), Arcata, CA; Indiana University (N.P.), Bloomington; Princeton University (M.P.), NJ; Temple University (T.D.L.), Philadelphia, PA; University of California (C.C.G., J.T.G.), Los Angeles; University of Chicago (H.J.B.), IL; University of Georgia (J.D.S.), Athens; University of Miami (L.A.F.), FL; University of Michigan (J.T.E.), Ann Arbor; University of North Carolina at Chapel Hill (J.P.M.); University of North Georgia (J.D.M.), Dahlonega; University of Oklahoma (S.A.), Norman; University of Pennsylvania (C.L.M.), Philadelphia; University of Pittsburgh (M.W.C., A.P.K.), PA; University of Washington (S.P.D.C.), Seattle; University of Wisconsin-Madison (A.B.); United States Air Force Academy (J.C.J., G.M.), Colorado Springs, CO; United States Military Academy (K.L.C.), West Point, NY; United States Naval Academy (A.S.), Annapolis, MD; United States Coast Guard Academy (P.G.O.), New London, CT; Virginia Tech (S.D., S.R.), Blacksburg; Wake Forest University (C.M.M., C.T.B.), Winston-Salem, NC; Wilmington College (B.H.D.), OH; Winston-Salem University (L.L.), NC.
Neurology. 2020 Nov 24;95(21):e2935-e2944. doi: 10.1212/WNL.0000000000010672. Epub 2020 Sep 9.
To examine the association between estimated age at first exposure (eAFE) to American football and clinical measures throughout recovery following concussion.
Participants were recruited across 30 colleges and universities as part of the National Collegiate Athletic Association (NCAA)-Department of Defense Concussion Assessment, Research and Education Consortium. There were 294 NCAA American football players (age 19 ± 1 years) evaluated 24-48 hours following concussion with valid baseline data and 327 (age 19 ± 1 years) evaluated at the time they were asymptomatic with valid baseline data. Participants sustained a medically diagnosed concussion between baseline testing and postconcussion assessments. Outcome measures included the number of days until asymptomatic, Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) composite scores, Balance Error Scoring System (BESS) total score, and Brief Symptom Inventory 18 (BSI-18) subscores. The eAFE was defined as participant's age at the time of assessment minus self-reported number of years playing football.
In unadjusted regression models, younger eAFE was associated with lower (worse) ImPACT Visual Motor Speed ( = 0.031, = 0.012) at 24-48 hours following injury and lower (better) BSI-18 Somatization subscores ( = 0.014, = 0.038) when the athletes were asymptomatic. The effect sizes were very small. The eAFE was not associated with the number of days until asymptomatic, other ImPACT composite scores, BESS total score, or other BSI-18 subscores.
Earlier eAFE to American football was not associated with longer symptom recovery, worse balance, worse cognitive performance, or greater psychological distress following concussion. In these NCAA football players, longer duration of exposure to football during childhood and adolescence appears to be unrelated to clinical recovery following concussion.
研究首次接触美式橄榄球（美式足球）的估计年龄（eAFE）与脑震荡后恢复期间临床指标之间的相关性。
参与者是作为美国全国大学体育协会（NCAA）-国防部脑震荡评估、研究和教育联合会的一部分从 30 所学院和大学招募的。共有 294 名 NCAA 美式橄榄球运动员（年龄 19±1 岁）在脑震荡后 24-48 小时接受评估，且具有有效的基线数据；327 名（年龄 19±1 岁）在无症状时接受评估，且具有有效的基线数据。参与者在基线测试和脑震荡后评估之间发生了经医学诊断的脑震荡。结果测量包括无症状天数、即时脑震荡后认知测试（ImPACT）综合评分、平衡错误评分系统（BESS）总分和简明症状问卷 18 项（BSI-18）子量表。eAFE 定义为评估时参与者的年龄减去自我报告的踢足球年数。
在未调整的回归模型中，较年轻的 eAFE 与受伤后 24-48 小时较低（较差）的 ImPACT 视觉运动速度（β=0.031，p=0.012）和无症状时较低（较好）的 BSI-18 躯体化子量表（β=0.014，p=0.038）相关。效应大小非常小。eAFE 与无症状天数、其他 ImPACT 综合评分、BESS 总分或其他 BSI-18 子量表均无相关性。
较早接触美式橄榄球与脑震荡后更长的症状恢复时间、更差的平衡能力、更差的认知表现或更大的心理困扰无关。在这些 NCAA 美式足球运动员中，童年和青少年时期接触足球的时间较长似乎与脑震荡后临床恢复无关。
