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动眼神经评估在确定急性脑震荡大学生运动员复学时间方面的预后效用:一项初步研究。

Prognostic Utility of Oculomotor Assessments in Determining Return-to-Learn Time in Acutely Concussed College Student-Athletes: A Pilot Study.

作者信息

Vanderhorst Maya, Rawlings Alex, Germansky Megan, Chodak Ayana, Krohn Amanda, Wilson Melissa, Bauman Robert, Emke Benjamin, Parody Robert, Bevilacqua Zachary W

机构信息

Department of Public Policy, Rochester Institute of Technology, Rochester, New York, USA.

Department of Exercise Science, Rochester Institute of Technology, Rochester, New York, USA.

出版信息

Neurotrauma Rep. 2023 Aug 11;4(1):515-521. doi: 10.1089/neur.2023.0027. eCollection 2023.

Abstract

We sought to discover which oculomotor test (King-Devick [KD], near point of convergence [NPC], and accommodative facility [AF]) would best produce a prognostic model for an RTL time frame. An observational cohort design was used to longitudinally track division I and III student-athletes with concussion at a private university in New York State. Measurements included pre-RTL oculomotor testing (NPC, KD, and AF), along with daily text messages and phone calls. Participants were considered returned-to-learn once they had returned to baseline symptoms and had attended 2 days of classes. Our data promote KD score and class attendance as the best-fit prognostic model, with every second accrued on the KD test equating to 5.29 h of RTL time. Further, attending class throughout recovery, versus not, shortened RTL time by a mean 170.50 h, or 7.1 days. Five variables produced a significant attenuating association with concussion symptoms: time post-injury ( = 0.01); caffeine ( = 0.05); alcohol ( = 0.01); music ( = 0.01); and physical activity ( = 0.01). Three variables produced a significant worsening association with concussion symptoms: screen time ( = 0.05); music ( = 0.01); and class attendance ( = 0.01). The findings present a preliminary evidence-based model to prognosticate RTL time. To our knowledge, this is the second longitudinal study, and the first overall, to present objective data for guiding and prognosticating RTL, respectively. Correspondingly, these data should assist clinicians with objectively steering RTL in-clinic.

摘要

我们试图找出哪种眼动测试(金-德维克测试[KD]、集合近点[NPC]和调节功能[AF])能最好地生成关于恢复到学习状态(RTL)时间框架的预后模型。采用观察性队列设计,对纽约州一所私立大学的一级和三级脑震荡学生运动员进行纵向跟踪。测量包括RTL前的眼动测试(NPC、KD和AF),以及每日的短信和电话沟通。一旦参与者恢复到基线症状并参加了两天课程,就被视为恢复学习。我们的数据表明,KD分数和上课出勤情况是最合适的预后模型,KD测试中每增加一秒相当于RTL时间增加5.29小时。此外,在整个恢复过程中上课与不上课相比,RTL时间平均缩短了170.50小时,即7.1天。有五个变量与脑震荡症状存在显著的减弱关联:受伤后时间(P = 0.01);咖啡因(P = 0.05);酒精(P = 0.01);音乐(P = 0.01);以及体育活动(P = 0.01)。有三个变量与脑震荡症状存在显著的加重关联:屏幕使用时间(P = 0.05);音乐(P = 0.01);以及上课出勤情况(P = 0.01)。这些发现提出了一个基于证据的初步模型来预测RTL时间。据我们所知,这是第二项纵向研究,也是第一项全面呈现客观数据以分别指导和预测RTL的研究。相应地,这些数据应有助于临床医生在临床上客观地指导RTL。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfdd/10457635/d270864233fb/neur.2023.0027_figure1.jpg

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