Harborview Injury Prevention and Research Center, Seattle, WA, USA.
University of Washington, Seattle, WA, USA.
NeuroRehabilitation. 2022;50(4):467-476. doi: 10.3233/NRE-210324.
Post-concussion return-to-learn (RTL) guidelines include implementation of school accommodations. Yet, little is known about physician recommendations for school accommodations and their impact, particularly among youth experiencing persistent post-concussive symptoms (PPCS).
We examined the association between physician recommended school accommodations and student outcomes among youth experiencing PPCS.
Data from a randomized comparative effectiveness trial was used. Physician recommended school accommodations (≤90 days post-injury) were collected via chart abstraction. Grade point average was extracted from school records. Reports of problems at school, concussion symptoms, health-related quality of life (HRQOL), anxiety symptoms, and depressive symptoms were collected by survey (at baseline, three months, and 12 months post study entry).
Of 200 participants (Mage = 14.7, 62% female), 86% were recommended school accommodations. Number of recommended school accommodations was positively associated with number of school problems at three months (aRR 1.18, 95% CI:1.12-1.24) and 12 months (aRR 1.11, 95% CI:1.05-1.18). No significant associations were found between recommended school accommodations and GPA, HRQOL, anxiety symptoms, or depressive symptoms.
Physicians recommend more school accommodations for students experiencing more school problems post-concussion. Appropriate implementation of RTL recommendations made by physicians by fostering partnerships among physicians, students, and schools may be needed to achieve student-centered RTL.
脑震荡后重返学习（RTL）指南包括实施学校适应措施。然而，对于医生对学校适应措施的建议及其影响，尤其是在经历持续性脑震荡后症状（PPCS）的青少年中，了解甚少。
我们研究了在经历 PPCS 的青少年中，医生推荐的学校适应措施与学生结果之间的关联。
使用了一项随机对照效果试验的数据。通过图表摘要收集了医生推荐的学校适应措施（受伤后≤90 天）。平均绩点（GPA）从学校记录中提取。通过调查（在基线、三个月和研究入组后 12 个月）收集了在校问题、脑震荡症状、健康相关生活质量（HRQOL）、焦虑症状和抑郁症状的报告。
在 200 名参与者中（平均年龄 14.7 岁，62%为女性），86%被建议采取学校适应措施。推荐的学校适应措施的数量与三个月（ARR 1.18，95%CI：1.12-1.24）和 12 个月（ARR 1.11，95%CI：1.05-1.18）时在校问题的数量呈正相关。在推荐的学校适应措施与 GPA、HRQOL、焦虑症状或抑郁症状之间未发现显著关联。
医生为经历更多脑震荡后在校问题的学生推荐更多的学校适应措施。可能需要通过医生、学生和学校之间建立伙伴关系，适当实施医生提出的 RTL 建议，以实现以学生为中心的 RTL。
