Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts.
Micheli Center for Sports Injury Prevention, Waltham, Massachusetts.
Clin J Sport Med. 2022 Jul 1;32(4):361-367. doi: 10.1097/JSM.0000000000000923. Epub 2021 Mar 9.
To examine if self-reported dizziness is associated with concussion symptoms, depression and/or anxiety symptoms, or gait performance within 2 weeks of postconcussion.
Cross-sectional study.
Research laboratory.
Participants were diagnosed with a concussion within 14 days of initial testing (N = 40). Participants were divided into 2 groups based on their Dizziness Handicap Inventory (DHI) score: 36 to 100 = moderate/severe dizziness and 0 to 35 = mild/no dizziness.
Participants were tested on a single occasion and completed the DHI, hospital anxiety and depression scale (HADS), Patient Health Questionnaire-9 (PHQ-9), and Post-Concussion Symptom Inventory (PCSI). Three different postural control tests were use: modified Balance Error Scoring System, single-/dual-task tandem gait, and a single-/dual-task instrumented steady-state gait analysis.
Comparison of patient-reported outcomes and postural control outcomes between moderate/severe (DHI ≥ 36) and mild/no (DHI < 36) dizziness groups.
Participants with moderate/severe dizziness (n = 19; age = 17.1 ± 2.4 years; 63% female) reported significantly higher symptom burden (PSCI: 43.0 ± 20.6 vs 22.8 ± 15.7; P = 0.001) and had higher median HADS anxiety (6 vs 2; P < 0.001) and depression (6 vs 1; P = 0.001) symptom severity than those with no/minimal dizziness (n = 21; age = 16.5 ± 1.9; 38% female). During steady-state gait, moderate/severe dizziness group walked with significantly slower single-task cadence (mean difference = 4.8 steps/minute; 95% confidence interval = 0.8, 8.8; P = 0.02) and dual-task cadence (mean difference = 7.4 steps/minute; 95% confidence interval = 0.7, 14.0; P = 0.04) than no/mild dizziness group.
Participants who reported moderate/severe dizziness reported higher concussion symptom burden, higher anxiety scores, and higher depression scores than those with no/mild dizziness. Cadence during gait was also associated with the level of dizziness reported.
研究在脑震荡后 2 周内,自我报告的头晕是否与脑震荡症状、抑郁和/或焦虑症状或步态表现有关。
横断面研究。
研究实验室。
参与者在初次测试后 14 天内被诊断为脑震荡(N=40)。根据他们的头晕残疾问卷(DHI)评分,参与者被分为两组:36 到 100=中度/重度头晕和 0 到 35=轻度/无头晕。
参与者单次接受测试,并完成 DHI、医院焦虑和抑郁量表(HADS)、患者健康问卷-9(PHQ-9)和脑震荡后症状问卷(PCSI)。使用了三种不同的姿势控制测试:改良平衡错误评分系统、单/双任务串联步态和单/双任务仪器化稳态步态分析。
中度/重度(DHI≥36)和轻度/无(DHI<36)头晕组之间患者报告的结果和姿势控制结果的比较。
中度/重度头晕组(n=19;年龄=17.1±2.4 岁;63%为女性)报告的症状负担显著更高(PCSI:43.0±20.6 与 22.8±15.7;P=0.001),且 HADS 焦虑(6 与 2;P<0.001)和抑郁(6 与 1;P=0.001)症状严重程度中位数均高于无/轻度头晕组(n=21;年龄=16.5±1.9;38%为女性)。在稳态步态中,中度/重度头晕组单任务步速明显较慢(平均差异=4.8 步/分钟;95%置信区间=0.8,8.8;P=0.02),双任务步速也较慢(平均差异=7.4 步/分钟;95%置信区间=0.7,14.0;P=0.04)。
报告中度/重度头晕的参与者报告的脑震荡症状负担更高,焦虑评分和抑郁评分均高于无/轻度头晕的参与者。步态时的步速也与报告的头晕程度有关。