Smulligan Katherine L, Carry Patrick, Smith Andrew C, Esopenko Carrie, Baugh Christine M, Wilson Julie C, Howell David R
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.
Phys Ther Sport. 2024 Sep;69:33-39. doi: 10.1016/j.ptsp.2024.07.002. Epub 2024 Jul 11.
To investigate dizziness, vestibular/oculomotor symptoms, and cervical spine proprioception among adults with/without a concussion history.
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.
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).
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.
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。
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。
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)。
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。