The Micheli Center for Sports Injury Prevention, Waltham, MA 02453, USA; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA 02115, USA.
The Micheli Center for Sports Injury Prevention, Waltham, MA 02453, USA; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA 02115, USA; Department of Pediatrics and Orthopedics, Harvard Medical School, Boston, MA 02115, USA.
J Sport Health Sci. 2021 Mar;10(2):138-144. doi: 10.1016/j.jshs.2020.10.007. Epub 2020 Oct 28.
The purpose of the study was to (1) examine the relationship between self-reported symptoms and concussion-related eye tracking impairments, and (2) compare gait performance between (a) adolescents with a concussion who have normal eye tracking, (b) adolescents with a concussion who have abnormal eye tracking, and (c) healthy controls.
A total of 30 concussed participants (age: 14.4 ± 2.2 years, mean ± SD, 50% female) and 30 controls (age: 14.2 ± 2.2 years, 47% female) completed eye tracking and gait assessments. The BOX score is a metric of pupillary disconjugacy, with scores <10 classified as normal and ≥10 abnormal. Symptoms were collected using the Post-Concussion Symptom Scale (PCSS), and gait speed was measured with triaxial inertial measurement units. We conducted a linear regression to examine the relationship between PCSS and BOX scores and a two-way mixed effects analysis of variance to examine the effect of group (abnormal BOX, normal BOX, and healthy control) on single- and dual-task gait speed.
There was a significant association between total PCSS score and BOX score in the concussion group (β = 0.16, p = 0.004, 95% confidence interval (95%CI): 0.06‒0.27), but not in the control group (β = 0.21, p = 0.08, 95%CI: -0.03 to 0.45). There were no significant associations between PCSS symptom profiles and BOX scores in the concussion or control groups. There were also no significant differences in single-task (Abnormal: 1.00 ± 0.14 m/s; Normal: 1.11 ± 0.21 m/s; Healthy: 1.14 ± 0.18 m/s; p = 0.08) or dual-task (Abnormal: 0.77 ± 0.15 m/s; Normal: 0.84 ± 0.21 m/s; Healthy: 0.90 ± 0.18 m/s; p = 0.16) gait speed.
The concussed group with impaired eye tracking reported higher total symptom severity, as well as worse symptom severity across the 5 PCSS symptom domain profiles. However, eye tracking deficits did not appear to be driven by any particular symptom domain. While not statistically significant, the slower gait speeds in those with abnormal BOX scores may still be clinically relevant since gait-related impairments may persist beyond clinical recovery.
本研究旨在：(1) 探讨自报告症状与脑震荡相关眼动追踪障碍之间的关系，以及 (2) 比较（a）眼动追踪正常的脑震荡青少年、（b）眼动追踪异常的脑震荡青少年和（c）健康对照组之间的步态表现。
共有 30 名脑震荡参与者（年龄：14.4±2.2 岁，平均值±标准差，50%为女性）和 30 名对照者（年龄：14.2±2.2 岁，47%为女性）完成了眼动追踪和步态评估。BOX 评分是瞳孔分离的度量，得分<10 为正常，得分≥10 为异常。症状采用脑震荡后症状量表（Post-Concussion Symptom Scale，PCSS）进行收集，步态速度采用三轴惯性测量单元进行测量。我们进行了线性回归分析，以检验 PCSS 和 BOX 评分之间的关系，以及双向混合效应方差分析，以检验组（异常 BOX、正常 BOX 和健康对照组）对单任务和双任务步态速度的影响。
脑震荡组中总 PCSS 评分与 BOX 评分之间存在显著关联（β=0.16，p=0.004，95%置信区间（95%CI）：0.06-0.27），但对照组中无显著关联（β=0.21，p=0.08，95%CI：-0.03 至 0.45）。脑震荡组和对照组中 PCSS 症状谱与 BOX 评分之间也没有显著关联。在单任务（异常：1.00±0.14 m/s；正常：1.11±0.21 m/s；健康：1.14±0.18 m/s；p=0.08）或双任务（异常：0.77±0.15 m/s；正常：0.84±0.21 m/s；健康：0.90±0.18 m/s；p=0.16）中，步态速度也没有显著差异。
有眼动追踪障碍的脑震荡组报告的总症状严重程度更高，以及在 5 个 PCSS 症状域谱中症状严重程度更差。然而，眼动追踪缺陷似乎不是由任何特定的症状域引起的。虽然没有统计学意义，但 BOX 评分异常者的步态速度较慢可能仍具有临床意义，因为与步态相关的障碍可能会在临床康复后持续存在。
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