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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >STEP UP! LESS PHYSICAL ACTIVITY AFTER CONCUSSION IS ASSOCIATED WITH PROLONGED CLINICAL RECOVERY AMONG ADOLESCENTS
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STEP UP! LESS PHYSICAL ACTIVITY AFTER CONCUSSION IS ASSOCIATED WITH PROLONGED CLINICAL RECOVERY AMONG ADOLESCENTS

机译：加紧！ 在脑震荡后的体育活性较少与青少年之间长期临床恢复相关

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Background: While many adolescent athletes recover from concussion within one month, some will not recover within this timeframe. Concussion management guidelines have evolved to de-emphasize rest and promote early re-introduction of sub-symptomatic physical activity. However, the optimal levels of physical activity during concussion recovery have yet to be determined. Hypothesis/Purpose: To investigate the association between quantity, frequency and intensity of physical activity after concussion with clinical recovery, defined as return-to-play (RTP) clearance from their physician. Methods: We conducted an observational, prospective cohort study of 26 youth athletes who sustained a concussion and were evaluated at two time points: initial visit (&14 days post-injury) and RTP clearance visit. Participants reported concussion symptoms using the Post-Concussion Symptom Inventory (PCSI). Participants wore an activity tracking device for the first two weeks after initial visit. This allowed us to quantify average steps/day, exercise frequency (average workouts/week), exercise duration (average time/workout), and exercise intensity (average/maximum HR during workouts). We grouped participants by clinical recovery timing (RTP &28 days vs. ≥28 days post-injury) and compared physical activity measures using independent samples t-tests. We then identified the sensitivity, specificity, and classification accuracy of cutpoints for each exercise variable using a Receiver Operating Characteristic (ROC) and Area under the Curve (AUC) analysis. Results: Half (n=13) of the participants required ≥28 days to receive RTP clearance. The two groups were similar in age, proportion of females, and past concussion history (Table 1). Those who required ≥28 days for RTP clearance reported significantly greater symptom severity at the initial examination than the RTP &28 days group, despite similar initial visit timing (Table 1). During the two weeks after the initial visit, the RTP ≥28 days group took fewer steps/day, exercised fewer days/week, and exercised fewer total minutes/week (Table 2). Among the activity/exercise variables examined, the highest classification accuracy between groups consisted of ≥9,100 average steps/day, ≥4 sessions/week, and spending ≥135 total minutes/week exercising (Table 3). Conclusion: Higher daily step counts and more frequent/longer exercise sessions were associated with clearance for RTP within 28 days from concussion in adolescent athletes. These preliminary results further support the benefit of physical activity during concussion recovery. However, our study cannot assess the causal effect of these findings, given that those who felt better earlier may have been willing to participate in more physical activity. Further research is needed to develop duration-, frequency- and intensity-specific physical activity level guidelines to aid clinicians in concussion management.
机译：背景：虽然许多青少年运动员在一个月内从脑震荡中恢复，但有些人不会在这个时间范围内恢复。脑震荡管理指南已经进化为休息，促进早期重新引入分症状体育活动。然而，尚未确定脑震荡恢复期间的物理活动的最佳水平。假设/目的：探讨脑震荡脑震荡后体积，频率和强度与临床恢复后的关联，定义为他们的医生的回报（RTP）清除。方法：我们对26个青年运动员进行了一项观察，前瞻性队列，他们持续了脑震荡，并在两次分别进行了评估：初步访问（＆amp; 14天后14天）和RTP清关访问。参与者使用震荡症状库存（PCSI）报告了震荡症状。参与者在初步访问后的前两周内穿过活动跟踪设备。这允许我们量化平均步骤/日，运动频率（平均锻炼/周），运动持续时间（平均时间/锻炼）和运动强度（锻炼期间的平均/最大小时）。我们通过临床恢复定时（RTP＆amp; LT; 28天与损伤后≥28天）分组参与者，并使用独立样品T检验比较身体活动措施。然后，我们使用曲线（AUC）分析下的接收器操作特性（ROC）和面积来确定每个运动变量的切口点的灵敏度，特异性和分类精度。结果：参与者的一半（n = 13）需要≥28天以获得RTP间隙。两组的年龄相似，女性比例和过去的脑震荡历史（表1）。对于RTP间隙所需≥28天的人报告初始检查的症状严重程度大于RTP＆amp; LT; 28天组，尽管有类似的初步访问时间（表1）。在初次访问后两周内，RTP≥28天的阶段/天少逐步，少日/周行使，并少完成总分钟/周（表2）。在检查的活动/运动变量中，组之间的最高分类准确性包括≥9,100平均步骤/日，≥4个会话/周，以及支出≥135总分钟锻炼（表3）。结论：较高的日常步数和更频繁/更长的运动会话与在青少年运动员脑震荡的28天内与RTP的间隙相关。这些初步结果进一步支持脑震荡恢复过程中的身体活动的好处。然而，我们的研究无法评估这些调查结果的因果效果，因为那些早些时候更好的人可能一直愿意参加更多的身体活动。需要进一步的研究来制定持续时间，频率和强度和强度特异性的身体活动级别指导，以​​帮助临床医生在脑脑管理中。

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