Optimal Physical and Cognitive Rest after Sports-Related Concussions among Youth

青少年运动相关脑震荡后的最佳身体和认知休息

• 批准号: 9335185
• 负责人: Jingzhen Ginger Yang
• 金额: $ 19.63万
• 依托单位: RESEARCH INST NATIONWIDE CHILDREN'S HOSP
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9335185
• 关键词: 17 year old; Acute; Affect; Age; Athletic; Attention; Brain; Brain Concussion; Caring; Cellular Phone; Characteristics; Child; Clinical; Clinical Management; Clip; Cognitive; Consent; Contracts; Data; Development; Devices; Diagnosis; Electronics; Enrollment; Exhibits; Fostering; Goals; Guidelines; Health; Hour; Individual; Injury; Knowledge; Lead; Legal Guardians; Length; Measures; Monitor; Neurocognitive Deficit; Outcome; Parents; Patient Self-Report; Patients; Pattern; Pediatric Hospitals; Phonation; Physical activity; Physicians; Post-Concussion Syndrome; Prospective Studies; Public Health; Randomized Controlled Trials; Recovery; Recruitment Activity; Reporting; Research; Rest; Risk; Schools; Seasons; Services; Shapes; Sleep; Sports; Surveys; Symptoms; Telephone; Text; Time; Training; Wrist; Youth; acute symptom; aged; chronic traumatic encephalopathy; clinical care; clinical practice; data format; evidence base; experience; functional disability; high risk; high school; junior high school; multidisciplinary; sex; tool; treatment planning; trial comparing

Project Summary Sports-related concussions are a major public health problem in the US, affecting 1.6 to 3.8 million youth each year. These concussions can disrupt brain function and contribute to long- term severe health conditions. Current guidelines for early clinical management of sports-related concussions call for physical and cognitive rest. However, these guidelines are not strongly evidence-based. Furthermore, the optimal levels of physical and cognitive rest needed to promote recovery are unknown, precluding personalized rest plans for youth with different concussion characteristics. The aims of this study are to: 1) objectively measure the physical and cognitive rest among youth with sports-related concussions, 2) identify optimal levels of rest in relation to post-concussive symptoms (PCS) and functional impairments, and 3) examine the relationship between the levels of rest and PCS and functional impairments for high versus low risk concussions. Youth ages 11 to 17 years old (n = 110) from 18 schools (15 high schools and 3 middle schools) will be recruited and enrolled at the beginning of season through sign consent from parents and assent from youth. Following a confirmed concussion diagnosis, injury information and acute clinical presentation will be assessed at the time of injury as part of routine clinical care. Participating youth will be followed to assess concussion outcomes, including functional impairments, at three time points: within 48 hours of injury, and at day 7 and day 45 post- concussion. A parent/legal guardian of the concussed youth will also be asked to report his/her child’s post-concussion outcomes at the three time points. In addition, participating youth will be monitored on daily physical and cognitive rest and PCS, using two electronic devices (Actigraph and Narrative Clip) and daily survey in various lengths until acute symptoms resolve. Objective and real-time data on the type, duration, and intensity of physical and cognitive rest/activity, collected here for the first time, will fill critical knowledge gaps regarding the level of rest needed for optimal recovery from high- or low-risk concussions. This study will provide formative data to support a subsequent randomized controlled trial comparing the effect of different levels of rest/activity on concussion outcomes. More importantly, the results will have a significant impact on clinical practice by shaping standards of care and informing treatment decisions about optimal rest/activity for sports-related concussions among youth. 1

项目摘要 运动相关脑震荡是美国的一个主要公共卫生问题， 每年有100万青年。这些脑震荡会破坏大脑功能，并导致长期- 严重的健康状况。运动相关疾病早期临床管理的现行指南 脑震荡需要身体和认知休息然而，这些指导方针并不强烈 循证此外，身体和认知休息的最佳水平需要 促进恢复是未知的，排除了个性化的休息计划，为青年与不同的 脑震荡特征本研究的目的是：（1）客观地测量物理 和认知休息的青年与运动有关的脑震荡，2）确定最佳水平的休息 与脑震荡后症状（PCS）和功能障碍有关，以及3）检查 高与低的休息水平和PCS与功能障碍之间的关系 有脑震荡的风险。 来自18所学校（15所高中和3所中学）的11至17岁青少年（n = 110） 将在赛季开始时通过父母的签字同意招募和注册， 青春的认同。在确诊脑震荡诊断后， 作为常规临床护理的一部分，将在受伤时评估临床表现。 参与的青少年将被跟踪评估脑震荡的结果，包括功能 损伤，在三个时间点：损伤后48小时内，以及损伤后第7天和第45天， 脑震荡脑震荡青少年的父母/法律的监护人也将被要求报告他/她 孩子在三个时间点的脑震荡后结果。此外，参与的青年将 使用两种电子设备（Activograph）监测每日身体和认知休息以及PCS 和叙述片段），每天进行不同长度的调查，直至急性症状消退。 关于身体和认知障碍的类型、持续时间和强度的客观和实时数据 休息/活动，这里收集的第一次，将填补关键的知识差距， 从高风险或低风险脑震荡中恢复所需的休息。本研究将提供 形成性数据，以支持随后的随机对照试验， 不同水平的休息/活动对脑震荡结果的影响。更重要的是，结果将有一个 通过制定护理标准和提供治疗信息对临床实践产生重大影响 关于青年运动相关脑震荡的最佳休息/活动的决定。 1

项目成果

Bidirectional Association Between Daily Physical Activity and Postconcussion Symptoms Among Youth.

• DOI: 10.1001/jamanetworkopen.2020.27486
• 发表时间: 2020-11-02
• 期刊: JAMA network open
• 影响因子: 13.8
• 作者: Yang J;Xu M;Sullivan L;Taylor HG;Yeates KO
• 通讯作者: Yeates KO

Concussion Recovery in Children and Adolescents: A Qualitative Study of Parents' Experiences.

• DOI: 10.1111/josh.13114
• 发表时间: 2022-03
• 期刊: The Journal of school health
• 作者: Sullivan L;Wysong M;Yang J
• 通讯作者: Yang J

Association of Self-Paced Physical and Cognitive Activities Across the First Week Postconcussion With Symptom Resolution in Youth.

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
• 发表时间: 2021
• 期刊: The Journal of head trauma rehabilitation
• 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
• 通讯作者: R

Change in health-related quality of life and functional disability over time post-concussion in youth.

青少年脑震荡后随时间的推移，与健康相关的生活质量和功能障碍发生变化。

• DOI: 10.1007/s11136-023-03480-4
• 发表时间: 2023
• 期刊: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation
• 作者: Recker,Robyn;Alshaikh,Enas;Kaur,Archana;Yeates,KeithOwen;Yang,Jingzhen
• 通讯作者: Yang,Jingzhen

Trajectories of Daily Postconcussion Symptoms in Children.

儿童日常脑震荡后症状的轨迹。

• DOI: 10.1097/htr.0000000000000878
• 发表时间: 2024
• 期刊: The Journal of head trauma rehabilitation
• 作者: Sullivan,Lindsay;Xu,Menglin;Yeates,KeithOwen;Alshaikh,Enas;Taylor,HGerry;Pommering,Thomas;Yang,Jingzhen
• 通讯作者: Yang,Jingzhen