Wingerson Mathew J, Wilson Julie C, Seehusen Corrine N, Walker Gregory A, Howell David R
Orthopedics, University of Colorado Anschutz School of Medicine, Aurora, United States.
Orthopedics, Children's Hospital Colorado, Aurora, United States.
Int J Sports Med. 2023 Jan;44(1):72-77. doi: 10.1055/a-1941-5673. Epub 2022 Sep 12.
Clinicians rely on objective concussion assessments that may be influenced by patient characteristics, creating difficulties in isolating the effect of concussion on patient function. The purpose of our study was to identify characteristics associated with performance on the Sport Concussion Assessment Tool 5 edition (SCAT5) 10-word recall test following adolescent concussion. We evaluated patients seen for care within 14 days of concussion (n=125; 15.2±1.6 years of age, range=11-18 years; 46% female; 6.9±3.4 days post-concussion). Patient demographic (age, sex, medical and concussion history, etc.), injury (timing of presentation, symptom severity, sport-type, etc.), and clinical test (Modified Balance Error Scoring System [mBESS], tandem gait) characteristics were assessed, in addition to SCAT5 immediate and delayed memory testing using the 10-word recall list. Immediate and delayed recall performance was significantly associated with concussion symptom burden and cognitive accuracy during tandem gait, although effect sizes were notably small. Specific variables such as age, sex, diagnosis of ADD/ADHD, and performance on other clinical assessments were not significantly associated with recall performance after controlling for covariates. Further, the 10-word recall list demonstrates specific advantages over previously used 5-word lists by way of decreased ceiling effects and reduced interference of inherent patient characteristics.
临床医生依赖于客观的脑震荡评估,但这些评估可能会受到患者特征的影响,从而在分离脑震荡对患者功能的影响方面造成困难。我们研究的目的是确定青少年脑震荡后在运动脑震荡评估工具第5版(SCAT5)10字回忆测试中的表现相关特征。我们评估了在脑震荡后14天内就诊的患者(n = 125;年龄15.2±1.6岁,范围11 - 18岁;46%为女性;脑震荡后6.9±3.4天)。除了使用10字回忆列表进行SCAT5即时和延迟记忆测试外,还评估了患者的人口统计学特征(年龄、性别、病史和脑震荡史等)、损伤情况(就诊时间、症状严重程度、运动类型等)以及临床测试(改良平衡误差评分系统[mBESS]、串联步态)特征。即时和延迟回忆表现与串联步态期间的脑震荡症状负担和认知准确性显著相关,尽管效应量明显较小。在控制协变量后,年龄、性别、注意力缺陷多动障碍(ADD/ADHD)诊断以及其他临床评估中的表现等特定变量与回忆表现无显著关联。此外,10字回忆列表通过降低天花板效应和减少患者固有特征的干扰,相对于先前使用的5字列表具有特定优势。