Lumb M J, Snegireva N, Welman K
Division of Movement Science and Exercise Therapy, The Movement Laboratory, Department of Exercise, Sport & Lifestyle Medicine, Faculty of Medicine and Health Sciences, University of Stellenbosch, Stellenbosch, Western Cape, South Africa.
S Afr J Sports Med. 2024 Jul 15;36(1):v36i1a17870. doi: 10.17159/2078-516X/2024/v36i1a17870. eCollection 2024.
Persisting symptoms after concussion (PSaC) are a pathological manifestation of head injuries that present with symptoms after the acute phase of head trauma has subsided. Insufficient research about PSaC has led to gaps in knowledge and incorrect terminology being applied. Furthermore, gaps exist in standardised assessment protocols and understanding of mental health symptoms associated with sports.
The study aimed to; 1) Determine expert consensus on appropriate terminology for symptoms lasting >4 weeks, 2) Investigate associations with mental health and postural stability symptoms, 3) Evaluate experts' views on quantitative balance and electroencephalogram (EEG) testing.
A Delphi-like survey was designed in REDCap and sent to identified experts in the field of sports-related concussions (SRC). Expert consensus was defined as ≥75% agreement.
Expert consensus identified the following mood and motor control symptoms being associated with PSaC: increases in emotional state (80%), irritability (87%), nervousness (87%), sadness (80%), balance impairment (80%), dizziness (87%) and feeling slow (80%). Numbness and tingling were not considered longer-term effects (80%). Additionally, 93% of respondents acknowledged mental health symptoms as potential longer-term effects, with 80% agreeing on inadequate current management. Respondents indicated PSaC are only somewhat adequately managed (73%) or not managed well enough (27%). The use of EEG and quantitative balance testing remains open for debate. The survey response rate was 21%.
Improving mental health management for athletes with PSaC and standardising terminology is crucial. Future research is required to establish effective diagnosis and treatment methods. Addressing these issues may result in better care and safer return to play for athletes.
脑震荡后持续症状（PSaC）是头部损伤的一种病理表现，在头部创伤急性期消退后出现症状。对PSaC的研究不足导致了知识空白和术语使用不当。此外，标准化评估方案以及对与运动相关的心理健康症状的理解也存在差距。
该研究旨在；1）确定关于持续超过4周症状的适当术语的专家共识，2）调查与心理健康和姿势稳定性症状的关联，3）评估专家对定量平衡和脑电图（EEG）测试的看法。
在REDCap中设计了一项类似德尔菲法的调查，并发送给体育相关脑震荡（SRC）领域的知名专家。专家共识定义为≥75%的一致性。
专家共识确定了以下与PSaC相关的情绪和运动控制症状：情绪状态增加（80%）、易怒（87%）、紧张（87%）、悲伤（80%）、平衡受损（80%）、头晕（87%）和感觉迟缓（80%）。麻木和刺痛不被视为长期影响（80%）。此外，93%的受访者承认心理健康症状是潜在的长期影响，80%的人认为目前的管理不足。受访者表示PSaC只是得到了一定程度的充分管理（73%）或管理不够好（27%）。脑电图和定量平衡测试的使用仍有待讨论。调查回复率为21%。
改善对患有PSaC的运动员的心理健康管理并规范术语至关重要。需要未来的研究来建立有效的诊断和治疗方法。解决这些问题可能会为运动员带来更好的护理和更安全的重返赛场机会。
