Cook Nathan E, Iverson Grant L, Maxwell Bruce, Zafonte Ross, Berkner Paul D
Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States.
Mass General Hospital for Children Sports Concussion Program, Boston, MA, United States.
Front Pediatr. 2021 Jan 13;8:606879. doi: 10.3389/fped.2020.606879. eCollection 2020.
The objective of this study was to determine whether adolescents with attention-deficit/hyperactivity disorder (ADHD) have prolonged return to school and sports following concussion compared to those without ADHD and whether medication status or concussion history is associated with recovery time. We hypothesized that having ADHD would not be associated with longer recovery time. This prospective observational cohort study, conducted between 2014 and 2019, examined concussion recovery among school sponsored athletics throughout Maine, USA. The sample included 623 adolescents, aged 14-19 years (mean = 16.3, standard deviation = 1.3 years), 43.8% girls, and 90 (14.4%) reported having ADHD. Concussions were identified by certified athletic trainers. We computed days to return to school (full time without accommodations) and days to return to sports (completed return to play protocol) following concussion. Adolescents with ADHD [median days = 7, interquartile range (IQR) = 3-13, range = 0-45] did not take longer than those without ADHD (median days = 7, IQR = 3-13, range = 0-231) to return to school ( = 22,642.0, = 0.81, = 0.01; log rank: = 0.059, = 0.81). Adolescents with ADHD (median days = 14, IQR = 10-20, range = 2-80) did not take longer than those without ADHD (median days = 15, IQR = 10-21, range = 1-210) to return to sports ( = 20,295.0, = 0.38, = 0.04; log rank: = 0.511, = 0.48). Medication status and concussion history were not associated with longer recovery times. Adolescents with ADHD did not take longer to functionally recover following concussion. Recovery times did not differ based on whether adolescents with ADHD reported taking medication to treat their ADHD or whether they reported a prior history of concussion.
本研究的目的是确定与没有注意力缺陷多动障碍（ADHD）的青少年相比，患有ADHD的青少年在脑震荡后恢复上学和运动的时间是否延长，以及用药情况或脑震荡病史是否与恢复时间相关。我们假设患有ADHD与更长的恢复时间无关。这项前瞻性观察队列研究于2014年至2019年进行，调查了美国缅因州学校赞助的体育活动中的脑震荡恢复情况。样本包括623名14 - 19岁的青少年（平均年龄 = 16.3岁，标准差 = 1.3岁），43.8%为女孩，90名（14.4%）报告患有ADHD。脑震荡由认证的运动训练师识别。我们计算了脑震荡后恢复上学（无特殊安排的全日制）的天数和恢复运动（完成恢复比赛方案）的天数。患有ADHD的青少年恢复上学的时间（中位数天数 = 7天，四分位间距[IQR] = 3 - 13天，范围 = 0 - 45天）并不比没有ADHD的青少年长（中位数天数 = 7天，IQR = 长3天，范围 = = 0.81，P = 0 = 0.059，P = 0.81）。患有ADHD的青少年恢复运动的时间（中位数天数 = 14天，IQR = 10 = 20天，范围 = 2 - 80天）并不比没有ADHD的青少年长（中位数天数 = 15天，IQR = 10 - 21天，范围 = 1 - 210天）（ = 20,295.0， = 0.38， = 0.04；对数秩检验： = 0.511， = 0.48）。用药情况和脑震荡病史与更长的恢复时间无关。患有ADHD的青少年脑震荡后功能恢复所需时间并不更长。恢复时间不因患有ADHD的青少年是否报告服用药物治疗ADHD或是否报告有脑震荡病史而有所不同。
