与运动相关脑震荡后动态运动测试（EXiT）表现相关的最小可检测变化分数及因素

Minimal Detectable Change Scores and Factors Associated With Dynamic Exertion Test (EXiT) Performance After Sport-Related Concussion.

作者信息

Gomes Dean, Sinnott Aaron, Zynda Aaron J, Kochick Victoria L, Ostop Sarah, Trbovich Alicia M, Feder Abigail, Collins Michael W, Kontos Anthony P

机构信息

University of Pittsburgh Medical Center Sports Medicine Concussion Program, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.

University of Pittsburgh Medical Center Sports Medicine Concussion Program, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina at Chapel Hill, North Carolina, North Carolina.

出版信息

Sports Health. 2024 Dec 18:19417381241298284. doi: 10.1177/19417381241298284.

DOI:10.1177/19417381241298284

PMID:39692232

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11653372/

Abstract

BACKGROUND

Factors associated with performance outside of a normative range on dynamic exertion test (EXiT) after sport-related concussion (SRC) remain unknown. This study examined the role of demographic and medical history factors on performance using minimal detectable change (MDC) cutoff scores in athletes being cleared to return to sport (RTS) from SRC.

HYPOTHESIS

Older age, being female, and body mass index (BMI) ≥50th percentile would be associated with worse EXiT performance and with increased likelihood of falling outside the normative MDC score range.

STUDY DESIGN

Cross-sectional.

LEVEL OF EVIDENCE

Level 3.

METHODS

Demographic factors, physiological metrics, performance metrics, symptoms, and ratings of perceived exertion were collected from 55 participants (age, 16.5 ± 2.3 years, 31.5% female) initially evaluated within 14 days of SRC who completed EXiT at medical clearance for RTS. Chi-square analyses, logistic and ordinal regressions, and 1-way analyses of variance examined factors associated with EXiT performance.

RESULTS

Most participants fell within the MDC score range on aerobic (71.2-100%), dynamic (75.8-100%), and change-of-direction (36.5-98.0%) tasks, and symptoms (96.2-100%). Older age was associated with better performance on Box Drill Shuffle ( < 0.01) and lower heart rate (HR) outcomes after Ball Toss ( = 0.04), Box Drill Shuffle ( < 0.01), Box Drill Carioca ( = 0.04), and Pro Agility ( < 0.01). Greater BMI was associated with higher HR after Ball Toss ( < 0.01) and worse posttreadmill aerobic performance ( < 0.01). Motion sickness history was associated with longer Zig Zag completion time ( = 0.036).

CONCLUSION

Most athletes presenting for clearance from concussion performed within MDC score ranges on EXiT metrics.

CLINICAL RELEVANCE

EXiT is accurate and effective in assessing response to dynamic exertion after SRC, and MDC scores can inform RTS decisions. Clinicians should consider age, BMI, and history of motion sickness when assessing EXiT performance.

摘要

背景

与运动相关脑震荡（SRC）后动态运动测试（EXiT）表现超出正常范围相关的因素尚不清楚。本研究使用最小可检测变化（MDC）临界值分数，探讨人口统计学和病史因素对从SRC恢复运动（RTS）的运动员EXiT表现的作用。

假设

年龄较大、女性以及体重指数（BMI）≥第50百分位数与较差的EXiT表现相关，且超出正常MDC分数范围的可能性增加。

研究设计

横断面研究。

证据水平

3级。

方法

收集了55名参与者（年龄16.5±2.3岁，31.5%为女性）的人口统计学因素、生理指标、运动表现指标、症状和自觉运动强度评分，这些参与者在SRC后14天内接受初始评估，并在医疗许可RTS时完成EXiT。卡方分析、逻辑回归和有序回归以及单因素方差分析检查了与EXiT表现相关的因素。

结果

大多数参与者在有氧（71.2 - 100%）、动态（75.8 - 100%）和变向（36.5 - 98.0%）任务以及症状（96.2 - 100%）方面的MDC分数范围内。年龄较大与在方块钻步洗牌任务中表现更好（<0.01）以及在抛球（=0.04）、方块钻步洗牌（<0.01）、方块钻步卡里约卡舞步（=0.04）和敏捷性测试（<0.01）后的心率（HR）较低相关。较高的BMI与抛球后较高的HR（<0.01）和较差的跑步机后有氧运动表现（<0.01）相关。晕动病史与更长的之字跑完成时间相关（=0.036）。