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注意缺陷多动障碍和学习障碍会改变与运动相关的脑震荡后的恢复情况和运动行为。

Attention-Deficit Hyperactivity Disorder and Learning Disabilities Modify Recovery and Sport Behavior Following Sport-Related Concussion.

作者信息

Pullen Jesse C, Wolfson Daniel I, Totten Douglas J, Jeckell Aaron S, Bonfield Christopher M, Zuckerman Scott L, Yengo-Kahn Aaron M

机构信息

Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, TN, USA.

Department of Neurosurgery, Rush University Medical Center, Chicago, IL, USA.

出版信息

Clin Pediatr (Phila). 2023 Feb;62(2):121-131. doi: 10.1177/00099228221113787. Epub 2022 Jul 26.

DOI:10.1177/00099228221113787
PMID:35883273
Abstract

Limited evidence exists concerning how a diagnosis of attention-deficit hyperactivity disorder and/or learning disabilities (ADHD/LD) modifies recovery and behavior following sport-related concussion (SRC). To understand how ADHD/LD modifies the post-SRC experience, we conducted a retrospective cohort study of concussed young athletes through phone interviews with patients and guardians. Outcomes included time until symptom resolution (SR) and return-to-learn (RTL), plus subjective changes in post-SRC activity and sports behavior. Multivariate Cox and logistic regression was performed, adjusting for biopsychosocial characteristics. The ADHD/LD diagnosis was independently associated with worse outcomes, including lower likelihood to achieve SR (hazard ratio [HR] = 0.62, 95% confidence interval [CI] = [0.41-0.94]; = .02) and RTL (HR = 0.55, 95% CI = [0.36-0.83]; < .01) at any time following injury, and increased odds of changing sport behavior after concussion (odds ratio [OR] = 3.26, 95% CI = [1.26-8.42], = .02), often to a safer style of play (62.5% vs 39.6%; = .02) or retiring from the sport (37.5% vs 18.5%; = .02). These results provide further evidence of the unique needs for athletes with ADHD/LD following SRC.

摘要

关于注意力缺陷多动障碍和/或学习障碍(ADHD/LD)的诊断如何影响与运动相关的脑震荡(SRC)后的恢复和行为,现有证据有限。为了了解ADHD/LD如何改变SRC后的经历,我们通过对患者及其监护人进行电话访谈,对脑震荡的年轻运动员进行了一项回顾性队列研究。结果包括症状缓解(SR)和恢复学习(RTL)的时间,以及SRC后活动和运动行为的主观变化。进行了多变量Cox和逻辑回归分析,并对生物心理社会特征进行了调整。ADHD/LD诊断与较差的结果独立相关,包括受伤后任何时候实现SR(风险比[HR]=0.62,95%置信区间[CI]=[0.41-0.94];P=.02)和RTL(HR=0.55,95%CI=[0.36-0.83];P<.01)的可能性较低,以及脑震荡后改变运动行为的几率增加(优势比[OR]=3.26,95%CI=[1.26-8.42],P=.02),通常转变为更安全的比赛方式(62.5%对39.6%;P=.02)或退出运动(37.5%对18.5%;P=.02)。这些结果为SRC后患有ADHD/LD的运动员的独特需求提供了进一步的证据。

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