Smulligan Katherine L, Carry Patrick, Wingerson Mathew J, Donahue Catherine, Wilson Julie C, Howell David R
Med Sci Sports Exerc. 2025 Feb 1;57(2):252-259. doi: 10.1249/MSS.0000000000003575.
This study aimed to examine associations between clinical measures (self-reported and clinician administered) and subsequent injury rates in the year after concussion return to play (RTP) among adolescent athletes.
We performed a prospective, longitudinal study of adolescents ages 13-18 yr. Each participant was initially assessed within 21 d of concussion and again within 5 d of receiving RTP clearance from their physician. Participants completed self-report measures: the Pittsburgh Sleep Quality Index and Tampa Scale of Kinesiophobia, and clinician-administered measures: single- and dual-task tandem gait and reaction time (RT; simple and clinical) assessments. They then completed monthly surveys for a year after RTP, which assessed exposure to injury (sport participation) and subsequent injuries (musculoskeletal or concussions) sustained. We used Poisson regression models to calculate injury rate ratios with the number of subsequent injuries sustained as the outcome, adjusted for RTP clearance time and competitive exposures for each measure.
Forty-one participants were included (age = 15.5 ± 1.3 yr, 56% female, 9.6 ± 4.6 d postconcussion; 38.0 ± 31.5 d to RTP). A higher injury rate per athletic exposure was observed for simple RT ≥ 505 ms versus <505 ms (injury rate ratio = 2.96, 95% confidence interval = 1.41-6.60, P = 0.005). Injury rates did not significantly differ by Pittsburgh Sleep Quality Index or Tampa Scale of Kinesiophobia scores, single/dual-task tandem gait time, or clinical RT.
Simple RT may be one risk factor that is associated with higher rates of subsequent injury after adolescent concussion. A simple RT measure incorporated into a comprehensive concussion RTP assessment may identify some individuals at higher risk of subsequent injury in the year after concussion, although further research is needed to better understand this relationship.
本研究旨在探讨青少年运动员脑震荡恢复参赛（RTP）后一年内临床测量指标（自我报告和临床医生实施的测量）与后续损伤率之间的关联。
我们对13 - 18岁的青少年进行了一项前瞻性纵向研究。每位参与者在脑震荡后21天内进行了首次评估，并在从医生处获得RTP许可后的5天内再次进行评估。参与者完成了自我报告测量：匹兹堡睡眠质量指数和坦帕运动恐惧量表，以及临床医生实施的测量：单任务和双任务串联步态及反应时间（RT；简单反应时间和临床反应时间）评估。然后，他们在RTP后的一年里每月完成一次调查，该调查评估了受伤暴露情况（运动参与）和随后遭受的损伤（肌肉骨骼损伤或脑震荡）。我们使用泊松回归模型计算损伤率比，将后续遭受的损伤数量作为结果，并针对每个测量指标对RTP许可时间和竞技暴露情况进行了调整。
纳入了41名参与者（年龄 = 15.5 ± 1.3岁，56%为女性，脑震荡后9.6 ± 4.6天；RTP时间为38.0 ± 31.5天）。与简单反应时间<505毫秒相比，简单反应时间≥505毫秒时每次运动暴露的损伤率更高（损伤率比 = 2.96，95%置信区间 = 1.41 - 6.60，P = 0.005）。匹兹堡睡眠质量指数或坦帕运动恐惧量表得分、单/双任务串联步态时间或临床反应时间对损伤率没有显著差异。
简单反应时间可能是青少年脑震荡后后续损伤率较高的一个风险因素。将简单反应时间测量纳入全面的脑震荡RTP评估中，可能会识别出一些在脑震荡后一年内后续受伤风险较高的个体，尽管需要进一步研究以更好地理解这种关系。
