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颈椎本体感觉与前庭/动眼功能:一项比较有和没有脑震荡病史的年轻成年人的观察性研究。

Cervical spine proprioception and vestibular/oculomotor function: An observational study comparing young adults with and without a concussion history.

作者信息

Smulligan Katherine L, Carry Patrick, Smith Andrew C, Esopenko Carrie, Baugh Christine M, Wilson Julie C, Howell David R

机构信息

Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA; Sports Medicine Center, Children's Hospital of Colorado, Aurora, CO, USA.

Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO, USA.

出版信息

Phys Ther Sport. 2024 Sep;69:33-39. doi: 10.1016/j.ptsp.2024.07.002. Epub 2024 Jul 11.

Abstract

OBJECTIVE

To investigate dizziness, vestibular/oculomotor symptoms, and cervical spine proprioception among adults with/without a concussion history.

METHODS

Adults ages 18-40 years with/without a concussion history completed: dizziness handicap inventory (DHI), visio-vestibular exam (VVE), and head repositioning accuracy (HRA, assesses cervical spine proprioception). Linear regression models were used to assess relationships between (1) concussion/no concussion history group and VVE, HRA, and DHI, and (2) DHI with HRA and VVE for the concussion history group.

RESULTS

We enrolled 42 participants with concussion history (age = 26.5 ± 4.5 years, 79% female, mean = 1.4± 0.8 years post-concussion) and 46 without (age = 27.0± 3.8 years, 74% female). Concussion history was associated with worse HRA (β = 1.23, 95% confidence interval [CI]: 0.77, 1.68; p < 0.001), more positive VVE subtests (β = 3.01, 95%CI: 2.32, 3.70; p < 0.001), and higher DHI scores (β = 9.79, 95%CI: 6.27, 13.32; p < 0.001) after covariate adjustment. For the concussion history group, number of positive VVE subtests was significantly associated with DHI score (β = 3.78, 95%CI: 2.30, 5.26; p < 0.001) after covariate adjustment, while HRA error was not (β = 1.10, 95%CI: -2.32, 4.51; p = 0.52).

CONCLUSIONS

Vestibular/oculomotor symptom provocation and cervical spine proprioception impairments may persist chronically (i.e., 3 years) after concussion. Assessing dizziness, vestibular/oculomotor and cervical spine function after concussion may inform patient-specific treatments to address ongoing dysfunction.

摘要

目的

调查有/无脑震荡病史的成年人的头晕、前庭/动眼症状和颈椎本体感觉。

方法

18至40岁有/无脑震荡病史的成年人完成:头晕残障量表(DHI)、视前庭检查(VVE)和头部重新定位准确性测试(HRA,评估颈椎本体感觉)。线性回归模型用于评估(1)脑震荡/无脑震荡病史组与VVE、HRA和DHI之间的关系,以及(2)脑震荡病史组中DHI与HRA和VVE之间的关系。

结果

我们招募了42名有脑震荡病史的参与者(年龄=26.5±4.5岁,79%为女性,脑震荡后平均1.4±0.8年)和46名无脑震荡病史的参与者(年龄=27.0±3.8岁,74%为女性)。在进行协变量调整后,脑震荡病史与较差的HRA(β=1.23,95%置信区间[CI]:0.77,1.68;p<0.001)、更多阳性的VVE子测试(β=3.01,95%CI:2.32,3.70;p<0.001)以及更高的DHI分数(β=9.79,95%CI:6.27,13.32;p<0.001)相关。对于脑震荡病史组,在进行协变量调整后,VVE阳性子测试的数量与DHI分数显著相关(β=3.78,95%CI:2.30,5.26;p<0.001),而HRA误差则不然(β=1.10,95%CI:-2.32,4.51;p=0.52)。

结论

脑震荡后,前庭/动眼症状激发和颈椎本体感觉障碍可能长期存在(即3年)。评估脑震荡后的头晕、前庭/动眼和颈椎功能可能有助于制定针对患者的治疗方案,以解决持续存在的功能障碍。

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