Abstract

Objective

To evaluate the role of time since injury on the factor structure of the Post-Concussion Symptom Scale (PCSS) for athletes after sustaining a sport-related concussion (SRC).

Methods

Adolescent athletes (n = 782) were dichotomized based on time since injury: 0–7 (EARLY; n = 321, age: 15.4 ± 1.9 years, 51.7% female), 8–14 (MIDDLE; n = 281, age: 15.8 ± 2.2 years, 54.8% female) and 15–30 days (LATE; n = 180, age: 15.6 ± 1.8 years, 52.8% female). An EFA was performed on the 22 variables of the PCSS for each of the three cohorts (primary factor loading of 0.6 to retain each item).

Results

EARLY had a five-component model (64% of total variance): 1) GLOBAL (18.0%; headache/dizziness/photosensitivity/phonosensitivity/difficulty concentrating), 2) FATIGUE/HYPERSOMNIA (16.4%; fatigue/drowsiness/mental fogginess/slowed down/hypersomnia), 3) AFFECTIVE (12.6%; more emotional/sadness), 4) INSOMNIA (9.0%; insomnia/trouble falling asleep), 5) SOMATIC (8.0%; vomiting/numbness). MIDDLE had a four-component model (63.1% of variance): 1) GLOBAL (19.4%; photosensitivity/headache/phonosensitivity/nausea/dizziness), 2) INSOMNIA/AFFECTIVE (14.4%; insomnia/more emotional/nervousness/trouble falling asleep), 3) SOMATIC/MEMORY (12.2%; difficulty remembering/numbness), and 4) HYPERSOMNIA (12.0%; drowsiness/hypersomnia). LATE had a four-component model (65.7% of variance): 1) VESTIBULAR/OCULAR (18.2%; vision/difficulty remembering/balance/fogginess/dizziness), 2) MIGRAINE (16.6%; photosensitivity/phonosensitivity/fatigue/headache), 3) AFFECTIVE (16.1%; sadness/nervousness/more emotional), and 4) INSOMNIA (7.6%; insomnia/trouble falling asleep).

Conclusions

The results of this study suggest greater time since injury modifies symptom factor structure in adolescent athletes with SRC. Specifically, symptom factors become more distinct with longer time since injury before first clinical visit. A GLOBAL symptom factor was observed for both EARLY and MIDDLE, but not in LATE. SOMATIC (i.e., numbness) was observed in EARLY/MIDDLE, but not LATE. Symptom factors in LATE seem to mirror concussion clinical sub-types from previous research (e.g., vestibular/ocular, migraine, affective, sleep).

中文翻译：

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A-07自从与运动相关的脑震荡青少年受伤以来脑震荡后症状的比例因子随时间的推移而变化

摘要

客观的

若要评估自受伤以来的时间对持续性脑震荡（SRC）后运动员脑震荡后症状量表（PCSS）因子结构的作用。

方法

青春期运动员（n = 782）根据受伤后的时间分为两类：0–7（早期； n = 321，年龄：15.4±1.9岁，女性为51.7％），8–14（中级； n = 281，年龄：15.8） ±2.2岁，女性54.8％）和15–30天（晚期； n = 180，年龄：15.6±1.8岁，女性52.8％）。对三个队列中的每个队列，对PCSS的22个变量执行EFA（主因子负荷为0.6，以保留每个项目）。

结果

EARLY有一个五部分模型（占总方差的64％）：1）全球（18.0％；头痛/头晕/光敏性/声敏性/困难集中性），2）疲劳/过敏症（16.4％；疲劳/困倦/精神错乱/减慢/充血），3）有效（12.6％;情绪/悲伤更多），4）失眠症（9.0％;失眠/难以入睡），5）躯体（8.0％;呕吐/麻木）。MIDDLE具有四部分模型（方差63.1％）：1）全球（19.4％；光敏性/头痛/音敏性/恶心/头晕），2）失眠/情感（14.4％；失眠/情绪/神经紧张/烦恼下降睡着了），3）身体/记忆力（12.2％;记忆力/麻木感）和4）睡眠不足症（12.0％;嗜睡/充血）。LATE具有四成分模型（方差65.7％）：1）前庭/眼（18.2％；

结论

这项研究的结果表明，自从损伤改变了患有SRC的青少年运动员的症状因子结构以来，花费了更多的时间。具体来说，自第一次受伤就诊以来，随着时间的延长，症状因素变得更加明显。在早期和中期都观察到了全球症状因素，但在晚期没有观察到。在早期/中期观察到躯体（即麻木），但未观察到晚期。LATE中的症状因素似乎反映了先前研究的脑震荡临床亚型（例如前庭/眼，偏头痛，情感性，睡眠）。