Price August M, Arvin Nicholas, Seagraves Benjamin, Burkhart Scott O, Knell Gregory
Children's Health Andrews Institute, Plano, TX 75024, USA.
Department of Psychiatry, University of Texas Southwestern, Dallas, TX 75390, USA.
Children (Basel). 2022 Sep 10;9(9):1371. doi: 10.3390/children9091371.
The purpose of this retrospective chart review was to compare sports-related concussion (SRC) recovery time in protracted recovery (≥28 days) patients who were prescribed physical therapy (PPT) with those who were only provided a home exercise program (HEP). We hypothesized PPT would be associated with shorter recovery times relative to HEP. Associations were evaluated with multivariable zero-truncated negative binomial regressions. Among the 48 (30.2%) PPT and 111 (69.8%) HEP patients, the majority were female (57.9%), the mean age was 15.3 ± 1.4 (PPT) and 14.2 ± 2.8 (HEP), and time to clinic was a median 6.0 (IQR = 3.0-27.0; PPT) and 7.0 (IQR = 3.0-23.0; HEP) days. After adjusting for demographic (age, sex) and clinical measures (concussion history, convergence, VOMS, PCSS score, and days to clinic), PPT unexpectedly was associated with 1.21 (95% CI: 1.05, 1.41) additional recovery days compared with HEP. One reason for this could be related to patients adhering to the number of a priori prescribed PT sessions which may or may not have aligned with the patient's symptom resolution. Future research should explore this hypothesis while aiming to evaluate the effect of PPT versus HEP using a randomized design. If confirmed, these findings are encouraging for patients who could not otherwise access or afford specialty rehabilitation.
本回顾性病历审查的目的是比较接受物理治疗（PPT）的迁延性恢复（≥28天）的运动相关脑震荡（SRC）患者与仅接受家庭锻炼计划（HEP）的患者的恢复时间。我们假设与HEP相比，PPT会使恢复时间更短。通过多变量零截断负二项回归评估相关性。在48例（30.2%）接受PPT治疗的患者和111例（69.8%）接受HEP治疗的患者中，大多数为女性（57.9%），平均年龄分别为15.3±1.4岁（PPT组）和14.2±2.8岁（HEP组），到诊所就诊的时间中位数分别为6.0天（IQR=3.0 - 27.0；PPT组）和7.0天（IQR=3.0 - 23.0；HEP组）。在调整了人口统计学因素（年龄、性别）和临床指标（脑震荡病史、集合、前庭-眼动筛查、PCSS评分和到诊所就诊天数）后，与HEP相比，PPT意外地与多1.21天（95%CI：1.05，1.41）的恢复时间相关。原因之一可能与患者坚持先验规定的PT疗程数量有关，这些疗程可能与患者症状缓解情况相符，也可能不符。未来的研究应探索这一假设，同时旨在采用随机设计评估PPT与HEP的效果。如果得到证实，这些发现对那些无法获得或负担不起专科康复治疗的患者来说是令人鼓舞的。
