评估基于学校的运动项目中的协作性脑震荡管理策略：前瞻性队列研究。
Assessment of a collaborative concussion management strategy in a school-based sport program: Prospective cohort study.
机构信息
Full Professor in the Department of Rehabilitation at Laval University in Québec, Que.
Coordinator of the football program at Académie St-Louis in Québec.
出版信息
Can Fam Physician. 2022 Mar;68(3):e100-e106. doi: 10.46747/cfp.6803e100.
OBJECTIVE
To analyze the implementation of a concussion management protocol in which a team physiotherapist is involved in the identification of concussions and return-to-play (RTP) decisions.
DESIGN
A prospective injury surveillance cohort study in a school-based Canadian football program (4 teams; grades 8 to 12) over 4 years. For years 1 to 2, the team physician made all RTP decisions; over years 3 to 4, the team physiotherapist was allowed to make some RTP decisions using pre-established criteria defined in the protocol.
SETTING
A high school in Québec, Que.
PARTICIPANTS
Male student athletes between 11 and 17 years old.
MAIN OUTCOME MEASURES
Same-season recurrence (SSR) of concussion symptoms following RTP.
RESULTS
A total of 119 concussions were identified (55 during the first 2 years and 64 during the last 2 years) during 27,741 athlete-exposures in 672 athlete-years for an incidence rate of 4.3 per 1000 athlete-exposures. During years 1 to 3, no SSR was observed following RTP clearance. During year 4 there was 1 case of SSR that occurred 11 days after clearance. The overall SSR rate of concussion symptoms following RTP clearance was 0.8%.
CONCLUSION
A very low rate of SSR was achieved whether the team physician made all RTP decisions or the team physiotherapist was allowed to make some of the RTP decisions through the terms of the protocol.
目的
分析一项涉及团队理疗师参与脑震荡识别和重返赛场（RTP）决策的脑震荡管理方案的实施情况。
设计
一项在加拿大基于学校的足球项目（4 个队；8 至 12 年级）中进行的前瞻性损伤监测队列研究，为期 4 年。在第 1 年至第 2 年期间，由队医做出所有 RTP 决策；在第 3 年至第 4 年期间，团队理疗师可以根据协议中预先设定的标准做出一些 RTP 决策。
地点
魁北克省的一所高中。
参与者
年龄在 11 至 17 岁之间的男性学生运动员。
主要观察指标
RTP 后同一赛季的脑震荡症状复发（SSR）。
结果
在 672 名运动员 672 个运动员年的 27741 次运动员暴露中，共确定了 119 例脑震荡（前 2 年 55 例，后 2 年 64 例），发生率为每 1000 次运动员暴露 4.3 例。在第 1 年至第 3 年期间，RTP 清除后未观察到 SSR。在第 4 年，有 1 例 SSR 在清除后 11 天发生。RTP 清除后脑震荡症状的总体 SSR 率为 0.8%。
结论
无论是队医做出所有 RTP 决策，还是根据协议条款允许团队理疗师做出一些 RTP 决策，SSR 的发生率都非常低。
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