Background

Clinically relevant scores of neck disability have been observed in adults post mild traumatic brain injury (mTBI), even in those who initially report to be recovered. Potentially cervical musculoskeletal and/or cervical sensorimotor impairments may underlie these persistent symptoms post mTBI.

Objective

To determine whether cervical impairments exist beyond expected recovery times following concussion compared to healthy controls (HC).

Study design

Observational cohort study.

Methods

Participants aged 18–60 years consisting of 39 HC, and 72 individuals, 4 weeks to 6 months post mTBI of which 35 considered themselves asymptomatic (Asymp), and 37 symptomatic (Symp). Cervical outcome measures included range and velocity of motion, flexor muscle endurance, presence of at least one dysfunctional cervical joint, joint position error -neutral and torsion, movement accuracy, smooth pursuit neck torsion test (SPNT) and balance.

Results

Individuals in the Symp mTBI group demonstrated significantly reduced: flexion and rotation range, rotation velocity, flexor endurance and movement accuracy as well as increased postural sway and a higher percentage had positive cervical joint dysfunction (p < 0.01]. The mTBI group who considered themselves recovered (Asymp)demonstrated significantly lower rotation range, flexor endurance, and a higher percentage had positive cervical joint dysfunction and positive SPNT (p < 0.05) compared to HCs.

Conclusion

Individuals reporting symptoms post mTBI demonstrated cervical spine musculoskeletal and sensorimotor impairments beyond expected recovery times. Those not reporting symptoms had fewer but some cervical impairments. The need for a comprehensive neck assessment should be considered, perhaps even in those not reporting symptoms.

中文翻译：

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轻度创伤性脑损伤后 4 周至 6 个月的颈椎肌肉骨骼和感觉运动障碍：一项观察性队列研究

背景

在轻度创伤性脑损伤 (mTBI) 后的成年人中观察到与临床相关的颈部残疾评分，即使在那些最初报告已康复的人中也是如此。潜在的颈部肌肉骨骼和/或颈部感觉运动障碍可能是 mTBI 后这些持续症状的基础。

客观的

确定与健康对照组 (HC) 相比，脑震荡后是否存在超出预期恢复时间的宫颈损伤。

学习规划

观察性队列研究。

方法

18-60 岁的参与者包括 39 名 HC 和 72 名个体，在 mTBI 后 4 周至 6 个月，其中 35 人认为自己无症状（无症状），37 人有症状（症状）。颈椎结果测量包括运动范围和速度、屈肌耐力、存在至少一个功能失调的颈椎关节、关节位置误差-中性和扭转、运动准确性、平滑追踪颈扭转测试 (SPNT) 和平衡。

结果

Symp mTBI 组的个体表现出显着降低：屈曲和旋转范围、旋转速度、屈肌耐力和运动准确性以及增加的姿势摆动和较高百分比的颈关节功能障碍阳性（p < 0.01]。认为自己的 mTBI 组与 HCs 相比，恢复 (Asymp) 的旋转范围、屈肌耐力显着降低，颈关节功能障碍阳性和 SPNT 阳性的比例更高 (p < 0.05)。

结论

在 mTBI 后报告症状的个体表现出超过预期恢复时间的颈椎肌肉骨骼和感觉运动障碍。那些没有报告症状的人有较少但有一些宫颈损伤。应该考虑对颈部进行全面评估的必要性，即使是那些没有报告症状的人。