Patel Rishi D, LaBella Cynthia R
Feinberg School of Medicine, Northwestern University, Chicago, Illinois (Drs Patel and LaBella); and Division of Orthopaedic Surgery and Sports Medicine, Lurie Children's Hospital, Chicago, Illinois (Dr LaBella).
J Head Trauma Rehabil. 2022;37(2):E129-E134. doi: 10.1097/HTR.0000000000000702.
Balance deficits are common after concussions in pediatric patients. This study evaluates 3 clinical tools for identifying postconcussion balance deficits in a pediatric population: (1) Post-Concussion Symptom Scale (PCSS); (2) Balance Error Scoring System (BESS); and (3) physical examination measures of balance: tandem gait (TG) and Romberg test.
Data were collected in a tertiary care outpatient pediatric sports medicine clinic.
English-speaking patients aged 8 to 17 years who presented to a tertiary care hospital-based pediatric sports medicine clinic and diagnosed with concussion between August 2014 and February 2018 were invited to participate. A total of 614 patients were screened and/or approached during the inclusion period and 500 were enrolled. Of those enrolled, 423 patients had complete data collected and analyzed.
This is a cross-sectional, observational data set from a longitudinal, prospective study.
Data extracted from patients' electronic medical records included physical examination, PCSS, and BESS scores from their initial visit. Descriptive statistics were calculated for the outcome measures. A logistic regression was performed to evaluate significant contributors to abnormal BESS score (≥25).
There were 423 patients (56.7% female; 14.7 ± 2.01 years old) included in the study. Overall, we identified 336 patients (79.4%) with balance difficulties. Of the 336 with balance difficulties, 284 (84.5%) reported "balance problems" and/or "dizziness" on PCSS, 153 (45.5%) had abnormal BESS scores (≥25), and 100 (29.8%) had an abnormality on either TG or Romberg test.
Balance difficulties were identified in close to 80% of children with concussions. Using PCSS and BESS along with physical examination measures, TG and Romberg test, identified more patients with balance deficits than using TG and Romberg test alone.
小儿脑震荡后平衡功能障碍很常见。本研究评估了3种用于识别小儿群体脑震荡后平衡功能障碍的临床工具：（1）脑震荡后症状量表（PCSS）；（2）平衡误差评分系统（BESS）；以及（3）平衡功能的体格检查指标：串联步态（TG）和罗姆伯格试验。
数据收集于一家三级医疗门诊儿科运动医学诊所。
邀请2014年8月至2018年2月期间到一家以三级医疗医院为基础的儿科运动医学诊所就诊并被诊断为脑震荡的8至17岁说英语的患者参与。纳入期内共筛查和/或接触了614名患者，500名患者被纳入研究。在纳入研究的患者中，423名患者有完整的数据收集和分析。
这是一个来自纵向前瞻性研究的横断面观察数据集。
从患者电子病历中提取的数据包括初次就诊时的体格检查、PCSS和BESS评分。计算结果指标的描述性统计量。进行逻辑回归以评估BESS评分异常（≥25）的显著影响因素。
本研究纳入了423名患者（56.7%为女性；年龄14.7±2.01岁）。总体而言，我们识别出336名（79.4%）有平衡功能障碍的患者。在这336名有平衡功能障碍的患者中，284名（84.5%）在PCSS上报告了“平衡问题”和/或“头晕”，153名（45.5%）BESS评分异常（≥25），100名（29.8%）在TG或罗姆伯格试验中有异常。
近80%的脑震荡儿童存在平衡功能障碍。与单独使用TG和罗姆伯格试验相比，使用PCSS、BESS以及体格检查指标TG和罗姆伯格试验能识别出更多有平衡功能障碍的患者。
