{"title":"运动脑震荡评估工具:用于检测脑震荡后症状加重的多维症状模型。","authors":"Eric O Ingram, Justin E Karr","doi":"10.1080/13854046.2024.2315735","DOIUrl":null,"url":null,"abstract":"<p><p><b>Objective:</b> Investigate whether a four-factor model of post-concussion symptoms (i.e. cognitive, physical, affective, and sleep-arousal) aids in identifying student-athletes with persistent concerns not reflected by a total symptom score. <b>Method:</b> Collegiate student-athletes (<i>N</i> = 32,066) from the Concussion Assessment Research and Education consortium completed the Sport Concussion Assessment Tool, 3rd edition Symptom Evaluation at baseline and two post-injury follow-ups (i.e. beginning RTP and 6-month). Confirmatory factor analysis was used to compare a one- and four-factor model of post-concussion symptoms. Normative reference data were compared across stratifications (e.g. sex, prior concussions, and number of pre-existing conditions) using Mann-Whitney <i>U</i> tests, and elevation rates (i.e. <math><mrow><mo>≥</mo></mrow></math>84th percentile) for subscales and the total score were recorded. <b>Results:</b> The four-factor model fit well before and after injury (CFIs > .95). Greater symptom severity on the subscale and total scores was associated with female sex (<i>ps</i><.001, <i>r</i> range: .07 to .14) and more pre-existing conditions (<i>ps</i><.001, <math><mrow><mi>η</mi></mrow></math><sup>2</sup> range: .01 to .04), while having more prior concussions was only related to total symptom scores (<i>ps</i><.001, <math><mrow><mi>η</mi></mrow></math><sup>2</sup><.01). After a concussion, a sizeable portion of student-athletes (i.e., RTP = 11.8%; 6-month = 8.3%) had subscale elevations despite no total score elevation. Physical subscale elevations at RTP were the most common (i.e., 11.9%), driven by head and neck pain. <b>Conclusion:</b> After a sport-related concussion, a four-factor symptom model can be used to assess persistent symptoms in collegiate student-athletes. Identifying athletes with domain-specific elevations may help clinicians identify areas for further assessment and, in some cases, personalized rehabilitation plans.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1683-1706"},"PeriodicalIF":3.0000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11330539/pdf/","citationCount":"0","resultStr":"{\"title\":\"The Sport Concussion Assessment Tool: A multidimensional symptom model for detecting elevated post-concussion symptoms.\",\"authors\":\"Eric O Ingram, Justin E Karr\",\"doi\":\"10.1080/13854046.2024.2315735\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Objective:</b> Investigate whether a four-factor model of post-concussion symptoms (i.e. cognitive, physical, affective, and sleep-arousal) aids in identifying student-athletes with persistent concerns not reflected by a total symptom score. <b>Method:</b> Collegiate student-athletes (<i>N</i> = 32,066) from the Concussion Assessment Research and Education consortium completed the Sport Concussion Assessment Tool, 3rd edition Symptom Evaluation at baseline and two post-injury follow-ups (i.e. beginning RTP and 6-month). Confirmatory factor analysis was used to compare a one- and four-factor model of post-concussion symptoms. Normative reference data were compared across stratifications (e.g. sex, prior concussions, and number of pre-existing conditions) using Mann-Whitney <i>U</i> tests, and elevation rates (i.e. <math><mrow><mo>≥</mo></mrow></math>84th percentile) for subscales and the total score were recorded. <b>Results:</b> The four-factor model fit well before and after injury (CFIs > .95). Greater symptom severity on the subscale and total scores was associated with female sex (<i>ps</i><.001, <i>r</i> range: .07 to .14) and more pre-existing conditions (<i>ps</i><.001, <math><mrow><mi>η</mi></mrow></math><sup>2</sup> range: .01 to .04), while having more prior concussions was only related to total symptom scores (<i>ps</i><.001, <math><mrow><mi>η</mi></mrow></math><sup>2</sup><.01). After a concussion, a sizeable portion of student-athletes (i.e., RTP = 11.8%; 6-month = 8.3%) had subscale elevations despite no total score elevation. Physical subscale elevations at RTP were the most common (i.e., 11.9%), driven by head and neck pain. <b>Conclusion:</b> After a sport-related concussion, a four-factor symptom model can be used to assess persistent symptoms in collegiate student-athletes. Identifying athletes with domain-specific elevations may help clinicians identify areas for further assessment and, in some cases, personalized rehabilitation plans.</p>\",\"PeriodicalId\":55250,\"journal\":{\"name\":\"Clinical Neuropsychologist\",\"volume\":\" \",\"pages\":\"1683-1706\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11330539/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Neuropsychologist\",\"FirstCategoryId\":\"102\",\"ListUrlMain\":\"https://doi.org/10.1080/13854046.2024.2315735\",\"RegionNum\":3,\"RegionCategory\":\"心理学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/2/18 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Neuropsychologist","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1080/13854046.2024.2315735","RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/2/18 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
The Sport Concussion Assessment Tool: A multidimensional symptom model for detecting elevated post-concussion symptoms.
Objective: Investigate whether a four-factor model of post-concussion symptoms (i.e. cognitive, physical, affective, and sleep-arousal) aids in identifying student-athletes with persistent concerns not reflected by a total symptom score. Method: Collegiate student-athletes (N = 32,066) from the Concussion Assessment Research and Education consortium completed the Sport Concussion Assessment Tool, 3rd edition Symptom Evaluation at baseline and two post-injury follow-ups (i.e. beginning RTP and 6-month). Confirmatory factor analysis was used to compare a one- and four-factor model of post-concussion symptoms. Normative reference data were compared across stratifications (e.g. sex, prior concussions, and number of pre-existing conditions) using Mann-Whitney U tests, and elevation rates (i.e. 84th percentile) for subscales and the total score were recorded. Results: The four-factor model fit well before and after injury (CFIs > .95). Greater symptom severity on the subscale and total scores was associated with female sex (ps<.001, r range: .07 to .14) and more pre-existing conditions (ps<.001, 2 range: .01 to .04), while having more prior concussions was only related to total symptom scores (ps<.001, 2<.01). After a concussion, a sizeable portion of student-athletes (i.e., RTP = 11.8%; 6-month = 8.3%) had subscale elevations despite no total score elevation. Physical subscale elevations at RTP were the most common (i.e., 11.9%), driven by head and neck pain. Conclusion: After a sport-related concussion, a four-factor symptom model can be used to assess persistent symptoms in collegiate student-athletes. Identifying athletes with domain-specific elevations may help clinicians identify areas for further assessment and, in some cases, personalized rehabilitation plans.
期刊介绍:
The Clinical Neuropsychologist (TCN) serves as the premier forum for (1) state-of-the-art clinically-relevant scientific research, (2) in-depth professional discussions of matters germane to evidence-based practice, and (3) clinical case studies in neuropsychology. Of particular interest are papers that can make definitive statements about a given topic (thereby having implications for the standards of clinical practice) and those with the potential to expand today’s clinical frontiers. Research on all age groups, and on both clinical and normal populations, is considered.