Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts.
Spaulding Rehabilitation Hospital and Spaulding Research Institute, Charlestown, Massachusetts.
Clin J Sport Med. 2021 Nov 1;31(6):e313-e320. doi: 10.1097/JSM.0000000000000806.
To investigate (1) if there are meaningful differences in baseline preseason cognitive functioning or symptom reporting between high school ice hockey players with and without prior concussions and (2) determine which health history variables predict symptom reporting.
Cross-sectional study.
High schools across the state of Maine.
Participants were 1616 male high school ice hockey players (mean age = 15.6 years; SD = 1.5 years) who completed baseline testing between 2009 and 2015.
Athletes were grouped according to their self-reported concussion history [0 (n = 1136), 1 (n = 321), 2 (n = 112), or 3+ (n = 47) previous concussions].
Cognitive functioning was measured by the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) battery, and symptom ratings were obtained from the Post-Concussion Symptom Scale.
There were no statistically significant differences between groups in cognitive functioning as measured by ImPACT. The group with ≥3 prior concussions endorsed higher total symptom scores, but the effect sizes were small and not statistically significant. In a multivariate model, prior treatment for headaches (not necessarily migraines), prior treatment for a psychiatric condition, and prior treatment for substance/alcohol use all significantly predicted total symptom scores, with concussion history being the weakest independent predictor.
Players with a history of prior concussions performed similarly to players with no prior concussions on cognitive testing. Health history factors were more strongly associated with symptom reporting than concussion history.
（1）调查高中冰球运动员中，既往有过脑震荡和无脑震荡者在基线赛前认知功能或症状报告上是否存在有意义的差异；（2）确定哪些健康史变量可以预测症状报告。
横断面研究。
缅因州各地的高中。
共有 1616 名男性高中冰球运动员（平均年龄=15.6 岁，标准差=1.5 岁）参加了 2009 年至 2015 年期间进行的基线测试。
根据他们自我报告的脑震荡史，运动员被分为以下几组[0（n=1136），1（n=321），2（n=112）或 3+（n=47）次既往脑震荡]。
认知功能通过即时脑震荡后评估和认知测试（ImPACT）进行测量，症状评定采用脑震荡后症状量表（Post-Concussion Symptom Scale）获得。
在 ImPACT 测试所测量的认知功能方面，各组间无统计学显著差异。既往有≥3 次脑震荡的组报告的总症状评分较高，但效应量较小且无统计学显著意义。在多变量模型中，既往头痛（不一定是偏头痛）治疗、既往精神疾病治疗以及既往物质/酒精使用治疗均显著预测总症状评分，而脑震荡史是最薄弱的独立预测因素。
有既往脑震荡史的运动员在认知测试中的表现与无既往脑震荡史的运动员相似。健康史因素与症状报告的相关性强于脑震荡史。
