School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada (Drs Teel, Marie Brossard-Racine, and Gagnon); Division of Neonatology (Dr Marie Brossard-Racine) and Division of Pediatric Emergency Medicine (Dr Gagnon), Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada; Department of Neurology and Neurosurgery, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada (Dr Marie Brossard-Racine); and Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada (Dr Corbin-Berrigan).
J Head Trauma Rehabil. 2021;36(2):E97-E107. doi: 10.1097/HTR.0000000000000633.
To determine whether a perceptual-cognitive training program using 3D-multiple object tracking (3D-MOT) can improve symptoms following acute pediatric concussion.
Research laboratory within a pediatric trauma center.
Children and adolescents (n = 62, age= 13.27 ± 2.50) with diagnosed concussion.
Randomized controlled trial. Children were randomized into either 3D-MOT, 2048 game, or standard care-only groups. Participants and parents completed the Post-Concussion Symptom Inventory (PCSI) at baseline, 4, 8, and 12 weeks postinjury. Intervention participants completed either the 3D-MOT protocol or the 2048 game at 6 sessions between the baseline and 4-week assessment.
A 3 (group) × 10 (time) mixed-model analysis of variance evaluated PCSI total scores. The rate of persistent postconcussive symptom (PPCS) was evaluated at 4 weeks using χ2 analysis.
Symptoms decreased throughout the study using both child-reported (F(9,374) = 22.03, P < .001) and parent-reported scores (F(9,370) = 28.06, P < .001). Twenty-four (44.4%) children met the study definition for PPCS using the child-reported PCSI, while 20 (37.7%) children had PPCS using parent reports. The intervention did not significantly affect symptom resolution or PPCS rates.
There is no benefit to prescribing 3D-MOT training for acute rehabilitation in pediatric patients with concussion and clinicians should instead focus on more effective programs.
确定使用三维多重目标跟踪(3D-MOT)的感知认知训练计划是否可以改善急性儿科脑震荡后的症状。
儿科创伤中心的研究实验室。
患有诊断性脑震荡的儿童和青少年(n=62,年龄=13.27±2.50)。
随机对照试验。将儿童随机分为 3D-MOT 组、2048 游戏组或仅标准护理组。参与者和家长在基线、4、8 和 12 周时完成脑震荡后症状问卷(PCSI)。干预组参与者在基线和 4 周评估之间完成 3D-MOT 方案或 2048 游戏 6 次。
3(组)×10(时间)混合模型方差分析评估 PCSI 总分。使用 χ2 分析在 4 周时评估持续性脑震荡后症状(PPCS)的发生率。
使用儿童报告(F(9,374)=22.03,P<.001)和家长报告(F(9,370)=28.06,P<.001)评分,症状在整个研究过程中均有所下降。24 名(44.4%)儿童使用儿童报告的 PCSI 符合 PPCS 的研究定义,而 20 名(37.7%)儿童使用家长报告有 PPCS。干预并没有显著影响症状缓解或 PPCS 发生率。
对于急性康复的儿科脑震荡患者,开具 3D-MOT 训练没有益处,临床医生应专注于更有效的方案。