Detecting altered postural control after cerebral concussion in athletes with normal postural stability
Detecting altered postural control after cerebral concussion in athletes with normal postural stability
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DOI：
10.1136/bjsm.2004.015909
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发表时间：
2005-11-01
影响因子：
18.4
通讯作者：
Stergiou, N
中科院分区：
文献类型：
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作者：
Cavanaugh, JT;Guskiewicz, KM;Stergiou, N
目的：为了确定近似熵（ApEn），一种来自非线性动力学的规律性统计量，是否可以检测脑震荡后姿势稳定性正常的运动员安静站立时姿势控制的变化。这项研究是回顾性的，在NCAA Division I（USA）的感觉组织测试（SOT）期间收集的压力中心（COP）数据的病例系列分析运动员受伤前和受伤后48小时内。受试者是21名男性和6名女性运动员，他们来自1997年至2003年期间持续脑震荡的各种运动。受伤后，运动员表现出与季前赛水平相当的正常姿势稳定性。为了比较，COP数据也收集了15名男性和15名女性健康的非运动员在两个场合。ApEn值计算COP前-后（AP）和内侧-外侧（ML）的时间series.Results：与健康受试者相比，运动员之间的COP振荡一般变得更有规律（较低的ApEn值）受伤后，尽管没有姿势不稳定。对于AP时间序列，在SOT条件1和2中ApEn值的下降比所有其他条件大得多（约为平均值标准误差的三倍）。对于ML时间序列，ApEn值在所有感觉条件下受伤后下降（F-1，F-55 = 6.36，p = 0.02）。结论：运动员在脑震荡后表现出正常的姿势稳定性，但在姿势控制方面表现出微妙的变化。ApEn的变化可能代表临床异常结果。COP振荡的近似熵分析可能是对现有运动员脑震荡评估方案的有价值的补充。
Objective: To determine if approximate entropy (ApEn), a regularity statistic from non-linear dynamics, could detect changes in postural control during quiet standing in athletes with normal postural stability after cerebral concussion.Methods: The study was a retrospective, case series analysis of centre of pressure ( COP) data collected during the Sensory Organization Test ( SOT) from NCAA Division I ( USA) athletes prior to and within 48 h after injury. Subjects were 21 male and six female athletes from a variety of sports who sustained a cerebral concussion between 1997 and 2003. After injury, athletes displayed normal postural stability equivalent to preseason levels. For comparison, COP data also were collected from 15 male and 15 female healthy non-athletes on two occasions. ApEn values were calculated for COP anterior-posterior (AP) and medial-lateral (ML) time series.Results: Compared to healthy subjects, COP oscillations among athletes generally became more regular ( lower ApEn value) after injury despite the absence of postural instability. For AP time series, declines in ApEn values were much larger in SOT conditions 1 and 2 ( approximately three times as large as the standard error of the mean) than for all other conditions. For ML time series, ApEn values declined after injury in all sensory conditions (F-1,F-55 = 6.36, p = 0.02).Conclusions: Athletes who demonstrated normal postural stability after concussion nonetheless displayed subtle changes in postural control. Changes in ApEn may have represented a clinically abnormal finding. ApEn analysis of COP oscillations may be a valuable supplement to existing concussion assessment protocols for athletes.