Age Differences in Recovery After Sport-Related Concussion: A Comparison of High School and Collegiate Athletes
Age Differences in Recovery After Sport-Related Concussion: A Comparison of High School and Collegiate Athletes
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DOI：
10.4085/1062-6050-51.4.04
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发表时间：
2016-02-01
影响因子：
3.3
通讯作者：
McCrea, Michael A.
中科院分区：
文献类型：
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作者：
Nelson, Lindsay D.;Guskiewicz, Kevin M.;McCrea, Michael A.
背景：年龄较小被假设为运动相关脑震荡后恢复时间延长的危险因素，但很少有研究直接评估急性恢复的年龄差异。目的：比较高中和大学运动员的临床康复模式。设计：前瞻性队列研究。背景：1999-2003年在运动医学背景下收集的大型、多中心前瞻性样本。研究对象：参加高中和大学接触和碰撞运动的脑震荡运动员（n = 621； 545名男性和76名女性）和未受伤的对照组（n = 150）（79%参加足球，15.7%参加足球，其余参加长曲棍球或冰球）。主要结果测量：参与者进行了症状评估（分级症状检查表）、认知评估（脑震荡标准化评估、纸笔神经心理测试）和姿势稳定性评估（平衡误差评分系统）。在脑震荡损伤后的几个时间点对运动员进行损伤前评估和连续随访：立即，损伤后3小时，以及第1、2、3、5、7、45或90天（在基线和3个损伤后时间点进行神经心理学测量）。结果：脑震荡的高中和大学运动员与未受伤的对照组的比较表明，高中运动员在认知（脑震荡标准化评估）测量中需要1到2天的时间才能恢复。与对照组在其他指标（症状、平衡）上的比较以及高中和大学脑震荡样本之间的直接比较显示，高中和大学群体在任何指标上的康复课程都没有差异。所有评估指标均在损伤后7天或之前发生组级恢复。结论：研究结果表明，在运动相关脑震荡后的恢复中不存在临床显著的年龄差异，因此，不需要对高中和大学运动员单独制定损伤管理方案。
Context: Younger age has been hypothesized to be a risk factor for prolonged recovery after sport-related concussion, yet few studies have directly evaluated age differences in acute recovery.Objective: To compare clinical recovery patterns for high school and collegiate athletes.Design: Prospective cohort study.Setting: Large, multicenter prospective sample collected from 1999-2003 in a sports medicine setting.Subjects: Concussed athletes (n = 621; 545 males and 76 females) and uninjured controls (n = 150) participating in high school and collegiate contact and collision sports (79% in football, 15.7% in soccer, and the remainder in lacrosse or ice hockey).Main Outcome Measure(s): Participants underwent evaluation of symptoms (Graded Symptom Checklist), cognition (Standardized Assessment of Concussion, paper-and-pencil neuropsychological tests), and postural stability (Balance Error Scoring System). Athletes were evaluated preinjury and followed serially at several time points after concussive injury: immediately, 3 hours postinjury, and at days 1, 2, 3, 5, 7, and 45 or 90 (with neuropsychological measures administered at baseline and 3 postinjury time points).Results: Comparisons of concussed high school and collegiate athletes with uninjured controls suggested that high school athletes took 1 to 2 days longer to recover on a cognitive (Standardized Assessment of Concussion) measure. Comparisons with the control group on other measures (symptoms, balance) as well as direct comparisons between concussed high school and collegiate samples revealed no differences in the recovery courses between the high school and collegiate groups on any measure. Group-level recovery occurred at or before 7 days postinjury on all assessment metrics.Conclusions: The findings suggest no clinically significant age differences exist in recovery after sport-related concussion, and therefore, separate injury-management protocols are not needed for high school and collegiate athletes.