Timing of Concussion Diagnosis Is Related to Head Impact Exposure Prior to Injury
Timing of Concussion Diagnosis Is Related to Head Impact Exposure Prior to Injury
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DOI：
10.1249/mss.0b013e3182793067
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发表时间：
2013-04-01
期刊：
影响因子：
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通讯作者：
Collins, Michael W.
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文献类型：
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作者：
Beckwith, Jonathan G.;Greenwald, Richard M.;Collins, Michael W.
Beckwith，J.G.，R. M. GREENWALD，J. J. CHU，J. J. CRISCO，S.罗森，S. M.杜马P. Broglio，T. W.麦卡利斯特M. GUSKIEWICZ，J. P. MIHALIK，S.安德森，B。P. G.施奈贝尔Brolinson，and M. W.柯林斯脑震荡诊断的时间与受伤前头部撞击暴露有关。医学科学体育锻炼：第45卷，第4期，第。747-754，2013年。目的：在运动环境中，脑震荡通常无法诊断，因为受伤后的体征和症状可能是轻微的，被受试者掩盖或无法识别。本研究比较了头部撞击的频率，位置和运动学反应的措施之前，立即和延迟脑震荡诊断的情况。研究方法：来自八所大学和六所高中球队的足球运动员在比赛中戴着仪器头盔（n = 1208），其中95人被诊断为脑震荡（共105例）。由仪表化头盔记录的加速度数据被减少到五个运动学指标：峰值线性和旋转加速度、Gadd严重性指数、头部损伤标准和头部速度变化（Δ v）。此外，每次撞击都被分配到四个一般位置区域（前、后、侧和顶部）中的一个，并在两个时期（1天和7天）内计算受伤前持续的撞击次数。结果如下：除最大旋转加速度（P = 0.284）外，所有与损伤相关的头部运动学指标在即刻诊断的病例中均显著高于延迟诊断的病例（P < 0.05）。延迟诊断的运动员在受伤当天（32.9 +/- 24.9，P < 0.001）和受伤后7天内（69.7 +/- 43.3，P = 0.006）的头部撞击次数显著高于立即诊断的运动员（16.5 +/- 15.1和50.2 +/- 43.6）。与脑震荡相关的撞击最常发生在头部前部（46%），其次是顶部（25%），侧面（16%）和背部（13%），撞击次数与时间诊断无关（chi（2）（3）= 4.72，P = 0.19）。结论：在撞击事件后立即诊断的脑震荡与最高的运动学测量相关，而那些以延迟诊断为特征的脑震荡之前有更多的撞击。
BECKWITH, J. G., R. M. GREENWALD, J. J. CHU, J. J. CRISCO, S. ROWSON, S. M. DUMA, S. P. BROGLIO, T. W. MCALLISTER, K. M. GUSKIEWICZ, J. P. MIHALIK, S. ANDERSON, B. SCHNEBEL, P. G. BROLINSON, and M. W. COLLINS. Timing of Concussion Diagnosis Is Related to Head Impact Exposure Prior to Injury. Med. Sci. Sports Exerc., Vol. 45, No. 4, pp. 747-754, 2013. Purpose: Concussions are commonly undiagnosed in an athletic environment because the postinjury signs and symptoms may be mild, masked by the subject, or unrecognized. This study compares measures of head impact frequency, location, and kinematic response before cases of immediate and delayed concussion diagnosis. Methods: Football players from eight collegiate and six high school teams wore instrumented helmets during play (n = 1208), of which 95 were diagnosed with concussion (105 total cases). Acceleration data recorded by the instrumented helmets were reduced to five kinematic metrics: peak linear and rotational acceleration, Gadd severity index, head injury criterion, and change in head velocity (Delta v). In addition, each impact was assigned to one of four general location regions (front, back, side, and top), and the number of impacts sustained before injury was calculated over two periods (1 and 7 days). Results: All head kinematic measures associated with injury, except peak rotational acceleration (P = 0.284), were significantly higher for cases of immediate diagnosis than delayed diagnosis (P < 0.05). Players with delayed diagnosis sustained a significantly higher number of head impacts on the day of injury (32.9 +/- 24.9, P < 0.001) and within 7 d of injury (69.7 +/- 43.3, P = 0.006) than players with immediate diagnosis (16.5 +/- 15.1 and 50.2 +/- 43.6). Impacts associated with concussion occurred most frequently to the front of the head (46%) followed by the top (25%), side (16%), and back (13%) with the number of impacts by location independent of temporal diagnosis (chi(2)(3) = 4.72, P = 0.19). Conclusions: Concussions diagnosed immediately after an impact event are associated with the highest kinematic measures, whereas those characterized by delayed diagnosis are preceded by a higher number of impacts.