Evolution of dizziness-related disability in children following concussion: a group-based trajectory analysis.

IF 1.5 4区医学 Q4 NEUROSCIENCES

Brain injury Pub Date : 2024-09-02 DOI:10.1080/02699052.2024.2393635

Pierre Langevin, Kathryn J Schneider, Michal Katz-Leurer, Mathilde Chevignard, Lisa Grilli, Adrienne Crampton, Isabelle Gagnon

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引用次数: 0

Abstract

Objective: This study aimed to identify Dizziness-Related Disability (DRD) recovery trajectories in pediatric concussion and assess clinical predictors of disability groups.

Materials and methods: In this prospective cohort study, 81 children (8-17 years) diagnosed with an acute concussion took part in 3 evaluation sessions (baseline, 3-month, and 6-month). All sessions included the primary disability outcome, the Dizziness Handicap Inventory (DHI) to create the DRD recovery trajectories using group-based multi-trajectory modeling analysis. Each independent variable included general patients' characteristics, premorbid conditions, function and symptoms questionnaires, and clinical physical measures; and were compared between the trajectories with logistic regression models.

Results: Low DRD (LD) trajectory (n = 64, 79%), and a High DRD (HD) trajectory (n = 17, 21%) were identified. The Predicting and Preventing Postconcussive Problems in Pediatrics (5P) total score (Odds Ratio (OR):1.50, 95% Confidence Interval (CI): 1.01-2.22), self-reported neck pain (OR:7.25, 95%CI: 1.24-42.36), and premorbid anxiety (OR:7.25, 95%CI: 1.24-42.36) were the strongest predictors of belonging to HD group.

Conclusions: Neck pain, premorbid anxiety, and the 5P score should be considered initially in clinical practice as to predict DRD at 3 and 6-month. Further research is needed to refine predictions and enhance personalized treatment strategies for pediatric concussion.

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儿童脑震荡后头晕相关残疾的演变：基于群体的轨迹分析。

目的：本研究旨在确定小儿脑震荡患者头晕相关残疾（DRD）的恢复轨迹，并评估残疾组别的临床预测因素：本研究旨在确定小儿脑震荡中头晕相关残疾（DRD）的恢复轨迹，并评估残疾组别的临床预测因素：在这项前瞻性队列研究中，81 名被诊断为急性脑震荡的儿童（8-17 岁）参加了 3 次评估（基线、3 个月和 6 个月）。所有评估均包括主要残疾结果--头晕障碍量表（DHI），以便利用基于群体的多轨迹建模分析创建 DRD 恢复轨迹。每个自变量都包括患者的一般特征、病前情况、功能和症状问卷以及临床体能测量；并通过逻辑回归模型对不同轨迹进行比较：结果：发现了低DRD（LD）轨迹（n = 64，79%）和高DRD（HD）轨迹（n = 17，21%）。预测和预防小儿脑震荡后问题（5P）总分（Odds Ratio (OR)：1.50，95% Confidence Interval (CI)：1.01-2.22）、自我报告的颈部疼痛（OR:7.25，95%CI：1.24-42.36）和病前焦虑（OR:7.25，95%CI：1.24-42.36）是预测属于HD组的最有力因素：结论：临床实践中应首先考虑颈痛、病前焦虑和 5P 评分，以预测 3 个月和 6 个月后的 DRD。还需要进一步的研究来完善预测结果，并加强针对小儿脑震荡的个性化治疗策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brain injury 医学-康复医学

CiteScore

3.50

自引率

5.30%

发文量

148

审稿时长

12 months

期刊介绍： Brain Injury publishes critical information relating to research and clinical practice, adult and pediatric populations. The journal covers a full range of relevant topics relating to clinical, translational, and basic science research. Manuscripts address emergency and acute medical care, acute and post-acute rehabilitation, family and vocational issues, and long-term supports. Coverage includes assessment and interventions for functional, communication, neurological and psychological disorders.