Association of Self-Paced Physical and Cognitive Activities Across the First Week Postconcussion With Symptom Resolution in Youth.
Association of Self-Paced Physical and Cognitive Activities Across the First Week Postconcussion With Symptom Resolution in Youth.
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脑震荡后第一周自定进度的身体和认知活动与青少年症状缓解的关系。
DOI：
10.1097/htr.0000000000000642
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
R
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作者：
Yang,Jingzhen;Yeates,KeithOwen;Shi,Junxin;Sullivan,Lindsay;Xun,Pengcheng;Taylor,HGerry;Tiso,Michael;Pommering,Thomas;MacDonald,James;Cohen,DanielM;Hautmann,Amanda;Asa,Nicole;Singichetti,Bhavna;Bailey,Matthew;Lu,Zhong-Lin;R
目的：探讨青少年脑震荡后第一周客观测量的、自定节奏的身体和认知活动与症状缓解的关系。地点：急诊科或脑震荡诊所。参与者：11至17岁的青少年，医生证实脑震荡。设计：重复测量的前瞻性队列。主要测量：从受伤到症状缓解的天数，基于青少年在脑震荡后症状量表上的每日评分。身体和认知活动分别使用ActiGraph和Narrative Clip进行评估。结果：共纳入83名青年参与者（n= 54[65%]男性，平均年龄= 14.2岁，SD= 1.9）。虽然自定节奏的日常身体和认知活动在受伤后的第一周增加，但每日脑震荡后症状减少。每日步数增加与早期症状缓解的可能性增加相关（风险比[HR]= 1.17； 95%可信区间[CI]， 1.02-1.34）。然而，在调整急性脑震荡后症状和其他协变量后，这种关联没有统计学意义。更长的上学时间与更早的症状缓解相关（调整后HR= 1.14; 95% CI, 1.02-1.27）。结论：自定节奏的身体和认知活动在损伤后的第一周内既不加速也不延长脑震荡的恢复。患有脑震荡的青少年可能有一定的自由来决定他们的活动水平。
Objective:To examine the association of objectively measured, self-paced physical and cognitive activities across the first week postconcussion with symptom resolution in youth.Setting:Emergency department or concussion clinics.Participants:Youth aged 11 to 17 years with physician-confirmed concussion.Design:Prospective cohort with repeated measures.Main Measure (s):Days from injury to symptom resolution, based on daily ratings by youth on the Post-Concussive Symptom Scale. Physical and cognitive activities were assessed using an ActiGraph and a Narrative Clip, respectively.Results:A total of 83 youth participants were included (n= 54 [65%] males; mean age= 14.2 years, SD= 1.9). While self-paced daily physical and cognitive activities increased across the first week postinjury, daily postconcussion symptoms decreased. Increased daily step count was associated with an increased likelihood of early symptom resolution (hazard ratio [HR]= 1.17; 95% confidence interval [CI], 1.02-1.34). However, this association was not statistically significant after adjusting for acute postconcussion symptoms and other covariates. Greater school attendance time was associated with earlier symptom resolution (adjusted HR= 1.14; 95% CI, 1.02-1.27).Conclusion:Self-paced physical and cognitive activities across the first week postinjury alone neither hastened nor prolonged concussion recovery. Youth with concussion may have some latitude to determine their activity levels.