Gagnon I, Forget R, Sullivan S J, Friedman D
Ecole de réadaptation, Faculté de Médecine, Université de Montréal, Québec, Canada.
Brain Inj. 1998 Oct;12(10):843-53. doi: 10.1080/026990598122070.
Mild Traumatic Brain Injury (TBI) is a common occurrence in the paediatric population and, as the concept of motor performance has not been assessed specifically in this population, the purpose of this study was to determine if motor performance deficits are present and can be objectively identified in a sample of children having sustained a mild TBI (Glasgow Coma Scale score 13-15). Twenty-eight children aged between 5 and 15 years were recruited immediately post-trauma. Subjects were considered normal on standard neurological exam at the time of discharge. They were assessed 13-18 days post-trauma using the Bruininks-Oseretsky Test of Motor Proficiency, a norm referenced clinical standardized assessment tool. Compared to published norms, motor performance was significantly lower in domains of balance, response speed and running speed an agility (t-test p < 0.01), and significantly higher in domains of upper extremity coordination and visual motor control (t-test p < 0.01). Although excellent performance can be observed in domains requiring upper limb coordination, motor planning and execution of motor tasks, deficits in balance and response speed can be identified in a significant number of children even after mild TBI. More specific and sensitive evaluations are necessary to identify the exact nature of the problems and evaluate their functional impact on daily activities.
轻度创伤性脑损伤（TBI）在儿科人群中很常见，由于尚未对该人群的运动表现概念进行专门评估，本研究的目的是确定在轻度TBI（格拉斯哥昏迷量表评分为13 - 15）患儿样本中是否存在运动表现缺陷以及能否客观识别这些缺陷。28名年龄在5至15岁之间的儿童在创伤后立即被招募。出院时，受试者在标准神经学检查中被认为正常。在创伤后13 - 18天，他们使用布鲁因inks - 奥塞雷茨基运动能力测试进行评估，这是一种基于常模的临床标准化评估工具。与已发表的常模相比，在平衡、反应速度和跑步速度及敏捷性方面，运动表现显著较低（t检验p < 0.01），而在上肢协调性和视觉运动控制方面显著较高（t检验p < 0.01）。尽管在需要上肢协调性、运动计划和运动任务执行的方面可以观察到出色表现，但即使是轻度TBI后，仍有相当数量的儿童存在平衡和反应速度缺陷。需要更具体、更敏感的评估来确定问题的确切性质，并评估其对日常活动的功能影响。
