1Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York.
2Concussion Management of New York, New York, New York; and.
J Neurosurg Pediatr. 2024 May 10;34(2):129-137. doi: 10.3171/2024.3.PEDS23565. Print 2024 Aug 1.
Increased adolescent sports participation has raised concerns about higher rates of concussions, a prevalent injury among young athletes with potential long-term effects. Discrepancies in concussion recovery and management protocols across various sports underscore a critical issue in youth athletics. This study aimed to examine the relationship between sport type and the number of games missed following a concussion to inform targeted management strategies.
Data from 7445 postinjury ImPACT tests for athletes aged 12-22 years, collected from 2009 to 2019, were analyzed across different sports: baseball, basketball, cheerleading, football, ice hockey, lacrosse, soccer, softball, swimming, track and field, volleyball, and wrestling. The number of days and normalized missed games (NMG), a metric accounting for the different number of games in a season for different sports, were used to evaluate the effect of concussions across different sports. ANOVA, t-tests, and linear regression analyses were performed to model the effect of sport type on games missed in a season while controlling for sex, age, concussion history, diagnosed learning disability (DLD), and attention-deficit/hyperactivity disorder (ADHD).
Multivariable linear regression analysis demonstrated that football participation significantly increased NMG (β 1.681, 95% CI 0.807-2.554; p < 0.001) and days missed (β 1.637, 95% CI 1.044-2.231; p < 0.001) after head injury. Concussion diagnoses were also found to significantly increase NMG (β 2.344, 95% CI 1.629-3.059; p < 0.001) and days missed (β 1.560, 95% CI 1.074-2.045; p < 0.001), as well as history of prior concussion (NMG: β 7.791, 95% CI 7.368-8.215; p < 0.001; days missed: β 5.232, 95% CI 4.945-5.520; p < 0.001). In contrast, factors such as age, sex, DLD, ADHD, and concussions causing loss of consciousness did not significantly affect NMG or days missed. ANOVA with Tukey Honest Significant Difference indicated that compared with football, ice hockey (mean difference [MD] 5.4 days, p = 0.011) and track and field (MD 4.1 days, p = 0.006) were associated with significantly more days being missed after head injury. Conversely, basketball (MD -3.0, p < 0.001) and volleyball (MD -2.6, p = 0.005) were associated with fewer missed games.
Adolescents playing football missed fewer days and games after concussion than other contact and noncontact sports, including ice hockey and track and field, raising questions about variations in return-to-play protocols and cultural attitudes within sports. Further research is needed to determine the factors affecting games missed across sport types in adolescent athletics and return-to-play protocols.
青少年参与体育运动的增加引发了人们对更高比率脑震荡的担忧，脑震荡是年轻运动员中普遍存在的潜在长期影响的伤害。不同运动项目之间的脑震荡康复和管理方案存在差异，这突显了青少年体育领域的一个关键问题。本研究旨在探讨运动类型与脑震荡后错过比赛的数量之间的关系，为有针对性的管理策略提供信息。
对 2009 年至 2019 年间收集的 7445 名 12-22 岁运动员受伤后的 ImPACT 测试数据进行了分析，这些运动员来自不同的运动项目：棒球、篮球、啦啦队、足球、冰球、长曲棍球、足球、垒球、游泳、田径、排球和摔跤。使用错过的天数和标准化错过的比赛（NMG），这是一个考虑不同运动项目赛季中比赛数量的指标，来评估不同运动项目中脑震荡的影响。采用方差分析、t 检验和线性回归分析来模拟运动类型对赛季中错过比赛的影响，同时控制性别、年龄、脑震荡史、诊断性学习障碍（DLD）和注意力缺陷/多动障碍（ADHD）。
多变量线性回归分析表明，与其他接触性和非接触性运动项目（包括冰球和田径）相比，足球运动参与者在头部受伤后，NMG（β 1.681，95%CI 0.807-2.554；p < 0.001）和错过的天数（β 1.637，95%CI 1.044-2.231；p < 0.001）明显增加。脑震荡诊断也被发现明显增加 NMG（β 2.344，95%CI 1.629-3.059；p < 0.001）和错过的天数（β 1.560，95%CI 1.074-2.045；p < 0.001），以及既往脑震荡史（NMG：β 7.791，95%CI 7.368-8.215；p < 0.001；错过的天数：β 5.232，95%CI 4.945-5.520；p < 0.001）。相比之下，年龄、性别、DLD、ADHD 和导致意识丧失的脑震荡等因素对 NMG 或错过的天数没有显著影响。方差分析和 Tukey 诚实显著差异检验表明，与足球相比，冰球（平均差异[MD] 5.4 天，p = 0.011）和田径（MD 4.1 天，p = 0.006）头部受伤后错过的天数明显更多。相反，篮球（MD-3.0，p < 0.001）和排球（MD-2.6，p = 0.005）与错过的比赛场次较少有关。
与冰球和田径等接触性和非接触性运动项目相比，青少年踢足球后错过的天数和比赛场次较少，这引发了人们对不同运动项目中康复和重返赛场方案以及运动文化态度存在差异的质疑。需要进一步研究以确定青少年运动中不同运动项目错过比赛的影响因素和重返赛场方案。
