Neck and Head Research Unit, SHRS, University of QLD, Brisbane, Australia.
Neck and Head Research Unit, SHRS, University of QLD, Brisbane, Australia; 2 Royal Brisbane and Women's Hospital, Physiotherapy Department, Brisbane, Australia.
Musculoskelet Sci Pract. 2022 Feb;57:102490. doi: 10.1016/j.msksp.2021.102490. Epub 2021 Nov 24.
Clinically relevant scores of neck disability have been observed in adults post mild traumatic brain injury (mTBI), even in those who initially report to be recovered. Potentially cervical musculoskeletal and/or cervical sensorimotor impairments may underlie these persistent symptoms post mTBI.
To determine whether cervical impairments exist beyond expected recovery times following concussion compared to healthy controls (HC).
Observational cohort study.
Participants aged 18-60 years consisting of 39 HC, and 72 individuals, 4 weeks to 6 months post mTBI of which 35 considered themselves asymptomatic (Asymp), and 37 symptomatic (Symp). Cervical outcome measures included range and velocity of motion, flexor muscle endurance, presence of at least one dysfunctional cervical joint, joint position error -neutral and torsion, movement accuracy, smooth pursuit neck torsion test (SPNT) and balance.
Individuals in the Symp mTBI group demonstrated significantly reduced: flexion and rotation range, rotation velocity, flexor endurance and movement accuracy as well as increased postural sway and a higher percentage had positive cervical joint dysfunction (p < 0.01]. The mTBI group who considered themselves recovered (Asymp)demonstrated significantly lower rotation range, flexor endurance, and a higher percentage had positive cervical joint dysfunction and positive SPNT (p < 0.05) compared to HCs.
Individuals reporting symptoms post mTBI demonstrated cervical spine musculoskeletal and sensorimotor impairments beyond expected recovery times. Those not reporting symptoms had fewer but some cervical impairments. The need for a comprehensive neck assessment should be considered, perhaps even in those not reporting symptoms.
即使在最初报告已康复的轻度创伤性脑损伤（mTBI）成年人中，也观察到与颈部功能障碍相关的临床评分。潜在的颈椎肌肉骨骼和/或颈椎感觉运动损伤可能是 mTBI 后这些持续症状的基础。
确定与健康对照组（HC）相比，在脑震荡后是否存在超出预期恢复时间的颈椎损伤。
观察性队列研究。
参与者年龄在 18-60 岁之间，包括 39 名 HC 和 72 名 mTBI 后 4 周到 6 个月的个体，其中 35 名自认为无症状（Asymp），37 名有症状（Symp）。颈椎结局测量包括运动范围和速度、屈肌耐力、至少一个功能障碍颈椎关节的存在、关节位置误差-中立和扭转、运动准确性、颈部扭转平滑追踪测试（SPNT）和平衡。
Symp mTBI 组的个体表现出明显的减少：屈曲和旋转范围、旋转速度、屈肌耐力和运动准确性，以及增加的姿势摇摆和更高比例的阳性颈椎关节功能障碍（p<0.01）。自我报告已康复（Asymp）的 mTBI 组与 HC 相比，旋转范围、屈肌耐力明显降低，阳性颈椎关节功能障碍和阳性 SPNT 的比例更高（p<0.05）。
报告 mTBI 后有症状的个体表现出颈椎肌肉骨骼和感觉运动损伤，超出了预期的恢复时间。那些没有报告症状的人有较少但仍有一些颈椎损伤。应考虑进行全面的颈部评估，即使是那些没有报告症状的人。
