Peripheral Vestibular and Balance Function in Athletes With and Without Concussion
Peripheral Vestibular and Balance Function in Athletes With and Without Concussion
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DOI：
10.1097/npt.0000000000000280
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发表时间：
2019-07-01
影响因子：
3.8
通讯作者：
Weise, Katherine K.
中科院分区：
文献类型：
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作者：
Christy, Jennifer B.;Cochrane, Graham D.;Weise, Katherine K.
背景和目的：根据最近关于运动相关性脑震荡(SRC)处理的最新共识声明，疑似SRC的运动员应接受全面的神经学检查。然而，没有定义将哪些措施包括在这种审查中。我们的目标是(1)评估没有SRC的运动员前庭和平衡测试的重测信度和标准化数据；(2)比较有无SRC的运动员在分测试上的差异；(3)确定脑震荡测试方案的分测试。方法：对87名健康运动员(n=87，平均年龄20.6岁；标准差=1.8岁；39名女性，48名男性)和28名SRC运动员(n=28，平均年龄20.7岁；标准差=1.9岁；女性11名，男性17名)进行转椅、颈前庭诱发肌源性电位(c-VEMP)和感觉组织测试(SOT)。其中一个子集(n=43)进行了两次测试。我们分析了测试的可靠性，并比较了使用SRC和不使用SRC的运动员的结果。结果：信度从差到强。使用SRC和不使用SRC的运动员在前庭外周功能(即转椅和c-VEMP)测试中无显著差异。患有SRC的运动员在前庭-眼反射(VOR)抵消增益、主观视觉垂直和水平差异以及SOT的所有条件下的得分显著低于对照组(P<；0.05)。讨论与结论：SRC不影响中频VOR或球囊功能。SRC确实影响了使用前庭输入感知垂直和姿势控制的能力，以及取消VOR的能力。提供视频摘要，了解作者的更多见解(参见补充数字内容1，可在以下网站获得)：http://links.lww.com/JNPT/A274).
Background and Purpose: According to the most recent consensus statement on management of sport-related concussion (SRC), athletes with suspected SRC should receive a comprehensive neurological examination. However, which measures to include in such an examination are not defined. Our objectives were to (1) evaluate test-retest reliability and normative data on vestibular and balance tests in athletes without SRC; (2) compare athletes with and without SRC on the subtests; and (3) identify subtests for concussion testing protocols. Methods: Healthy athletes (n = 87, mean age 20.6 years; standard deviation = 1.8 years; 39 female and 48 male) and athletes with SRC (n = 28, mean age 20.7 years; standard deviation = 1.9 years; 11 female and 17 male) were tested using rotary chair, cervical vestibular-evoked myogenic potential (c-VEMP), and the Sensory Organization Test (SOT). A subset (n = 43) were tested twice. We analyzed reliability of the tests, and compared results between athletes with and without SRC. Results: Reliability ranged from poor to strong. There was no significant difference between athletes with and without SRC for tests of peripheral vestibular function (ie, rotary chair and c-VEMP). Athletes with SRC had significantly worse scores (P < 0.05) on vestibular-ocular reflex (VOR) cancellation gain, subjective visual vertical and horizontal variance, and all conditions of the SOT. Discussion and Conclusion: SRC did not affect medium frequency VOR or saccular function. SRC did affect the ability to use vestibular inputs for perception of vertical and postural control, as well as ability to cancel the VOR. Video Abstract available for more insights from the authors ( see Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A274).