Exertion Testing in Youth with Mild Traumatic Brain Injury/Concussion
Exertion Testing in Youth with Mild Traumatic Brain Injury/Concussion
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DOI：
10.1249/mss.0000000000000682
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发表时间：
2015-11-01
影响因子：
4.1
通讯作者：
Timmons, Brian W.
中科院分区：
文献类型：
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作者：
Dematteo, Carol;Volterman, Kimberly A.;Timmons, Brian W.
关于轻度创伤性脑损伤/脑震荡后恢复活动（RTA）的决定是脑震荡管理中最困难和最有争议的领域之一，特别是对于年轻人。本研究探讨了如何青年脑震荡后综合征（PCS）的影响，是否标准化的运动测试，使用麦克马斯特全面进步连续自行车测试可以有助于临床决策安全RTA.Methods五十四青年（8.5-18.3年），以前确认脑震荡参加了这项研究。每个参与者在自行车测力计上进行运动测试，并在以下时间点完成脑震荡后症状量表：运动前（基线），运动后5分钟和30分钟以及运动后24小时。一个修改后的脑震荡后症状量表管理在2分钟的时间间隔在exercise.Results参与者有一个平均SD症状持续时间为6.3 +/- 6.9个月后，最近的脑震荡损伤，与中位数为4.1个月（范围，0.7-35个月）。63%的参与者在运动测试中出现症状。症状特征（数量和严重程度）显著影响50%峰值机械功率时的用力感知。在急性症状评估期间（运动后30分钟），头痛（P = 0.39）、恶心（P = 0.63）和头晕（P = 0.35）没有变化。然而，症状的数量和严重程度在24小时内都有显着改善，56.8%的年轻人表现出改善。从最近受伤的时间有一个显着的影响，在基线的症状评分，30分钟后，劳累，24 h后explore.Conclusions的症状和准备RTA的评估，特别是在年轻人谁是缓慢恢复的，预防测试有重要的作用。总的来说，对大多数年轻人来说，有控制的运动似乎可以缓解症状。
Purpose The decision regarding return to activity (RTA) after mild traumatic brain injuries/concussion is one of the most difficult and controversial areas in concussion management, particularly for youth. This study investigated how youth with postconcussion syndrome (PCS) are affected by exertion and whether standardized exertion testing using the McMaster All-Out Progressive Continuous Cycling Test can contribute to clinical decision making for safe RTA.Methods Fifty-four youth (8.5-18.3 yr) with a previously confirmed concussion participated in the study. Each participant performed exertion testing on a cycle ergometer and completed a Postconcussion Symptom scale at the following time points: before exertion (baseline), 5 and 30 min, and 24 h after exertion. A modified Postconcussion Symptom scale was administered at 2-min intervals during exertion.Results Participants had a mean SD symptom duration of 6.3 +/- 6.9 months after the most recent concussive injury, with a median of 4.1 months (range, 0.7-35 months). Sixty-three percent of participants had symptoms during exertion testing. Symptom profile (number and severity) significantly affected perception of exertion at 50% peak mechanical power. During acute assessment of symptoms (30-min after exertion), headache (P = 0.39), nausea (P = 0.63), and dizziness (P = 0.35) did not change. However, both the number and severity of symptoms significantly improved over 24 h, with 56.8% of youth showing improvements. The time from the most recent injury had a significant effect on the symptom score at baseline, 30 min after exertion, and 24 h after exertion.Conclusions Exertion testing has an important role in the evaluation of symptoms and readiness to RTA, particularly in youth who are slow to recover. Overall, controlled exertion seemed to lesson symptoms for most youth.