Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA.
Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
Ann Biomed Eng. 2024 Oct;52(10):2884-2896. doi: 10.1007/s10439-024-03575-0. Epub 2024 Jul 8.
Sporting helmets contain force attenuating materials which reduce traumatic head injury risk and may influence sport-related concussion (SRC) sequelae. The purpose of this study was to examine the association of sport helmet status with SRC-clinical presentation and recovery trajectories in men's collegiate athletes. Sport helmet status was based on the nature of sports being either helmeted/non-helmeted. 1070 SRCs in helmeted (HELM) sports (Men's-Football, Ice Hockey, and Lacrosse), and 399 SRCs in non-helmeted (NOHELM) sports (Men's-Basketball, Cheerleading, Cross Country/Track & Field, Diving, Gymnastics, Soccer, Swimming, Tennis, and Volleyball) were analyzed. Multivariable negative binomial regression models analyzed associations between sport helmet status and post-injury cognition, balance, and symptom severity, adjusting for covariate effects (SRC history, loss of consciousness, anterograde/retrograde amnesia, event type). Kaplan-Meier curves evaluated median days to: initiation of return to play (iRTP) protocol, and unrestricted RTP (URTP) by sport helmet status. Log-rank tests were used to evaluate differential iRTP/URTP between groups. Two independent multivariable Weibull accelerated failure time models were used to examine differential iRTP and URTP between groups, after adjusting for aforementioned covariates and symptom severity score. Overall, the median days to iRTP and URTP was 6.3 and 12.0, respectively, and was comparable across NOHELM- and HELM-SRCs. Post-injury symptom severity was lower (Score Ratio 0.90, 95%CI 0.82, 0.98), and cognitive test performance was higher (Score Ratio 1.03, 95%CI 1.02, 1.05) in NOHELM-compared to HELM-SRCs. Estimated time spent recovering to iRTP/URTP was comparable between sport helmet status groups. Findings suggest that the grouping of sports into helmeted and non-helmeted show slight differences in clinical presentation but not recovery.
运动头盔内含有可减轻外力冲击的材料，能降低创伤性头部损伤的风险，并可能影响与运动相关的脑震荡（SRC）的后续影响。本研究的目的是检验男子大学生运动员运动头盔佩戴情况与 SRC 临床表现和恢复轨迹之间的关系。运动头盔状态基于运动项目是否戴头盔/不戴头盔。对 1070 例头盔运动（男子足球、冰球和曲棍球）中的 SRC 和 399 例非头盔运动（男子篮球、啦啦队、越野/田径、跳水、体操、足球、游泳、网球和排球）中的 SRC 进行了分析。多变量负二项回归模型分析了运动头盔状态与受伤后认知、平衡和症状严重程度之间的关系，调整了协变量的影响（SRC 病史、意识丧失、顺行/逆行性遗忘、事件类型）。Kaplan-Meier 曲线评估了按运动头盔状态达到：重返比赛（iRTP）方案起始日和无限制 RTP（URTP）的中位数天数。对数秩检验用于评估各组间 iRTP/URTP 的差异。使用两个独立的多变量 Weibull 加速失效时间模型，在调整上述协变量和症状严重程度评分后，研究各组间 iRTP 和 URTP 的差异。总体而言，iRTP 和 URTP 的中位数天数分别为 6.3 天和 12.0 天，在非头盔和头盔 SRC 之间相似。受伤后症状严重程度较低（评分比 0.90，95%CI 0.82，0.98），认知测试表现较高（评分比 1.03，95%CI 1.02，1.05）在非头盔 SRC 中。达到 iRTP/URTP 的恢复时间在运动头盔状态组之间相当。研究结果表明，将运动项目分为头盔和非头盔组，在临床表现上略有不同，但在恢复方面没有差异。
