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The Diagnostic Utility of Cervical Spine Proprioception for Adolescent Concussion.
Smulligan, Katherine L; Magliato, Samantha N; Keeter, Carson L; Wingerson, Mathew J; Smith, Andrew C; Wilson, Julie C; Howell, David R.
Afiliação
  • Smulligan KL; Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado.
  • Magliato SN; Sports Medicine Center, Children's Hospital of Colorado, Aurora, Colorado.
  • Keeter CL; Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado.
  • Wingerson MJ; Sports Medicine Center, Children's Hospital of Colorado, Aurora, Colorado.
  • Smith AC; Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado.
  • Wilson JC; Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado.
  • Howell DR; Sports Medicine Center, Children's Hospital of Colorado, Aurora, Colorado.
Clin J Sport Med ; 2024 Jul 02.
Article em En | MEDLINE | ID: mdl-38953712
ABSTRACT

OBJECTIVE:

Cervical spine proprioception may be impaired after concussion. Our objective was to determine the diagnostic utility of cervical spine proprioception for adolescent concussion.

DESIGN:

Cross-sectional.

SETTING:

Research laboratory.

PARTICIPANTS:

Adolescents ≤18 days of concussion and uninjured controls.

INTERVENTIONS:

N/A. MAIN

OUTCOMES:

Head repositioning accuracy (HRA) testing, a measure of cervical spine proprioception. The HRA test involved patients relocating their head back to a neutral starting position with eyes closed after maximal cervical spine flexion, extension, and right and left rotations. The overall HRA error score was the mean error (distance from the starting point to self-reported return to neutral) across 12 trials 3 trials in each direction. We used t-tests to compare group means and logistic regression (outcome = group, predictor = HRA, covariates) to calculate odds ratios. We used a receiver operator characteristic curve to evaluate area under the curve (AUC) and calculate the optimal HRA cutpoint to distinguish concussion from controls.

RESULTS:

We enrolled and tested 46 participants with concussion (age = 15.8 ± 1.3 years, 59% female, mean = 11.3 ± 3.3 days postconcussion) and 83 uninjured controls (age = 16.1 ± 1.4 years, 88% female). The concussion group had significantly worse HRA than controls (4.3 ± 1.6 vs 2.9 ± 0.7 degrees, P < 0.001, Cohen d = 1.19). The univariable HRA model AUC was 0.81 (95% CI = 0.73, 0.90). After adjusting for age, sex, and concussion history, the multivariable model AUC improved to 0.85 (95% CI = 0.77, 0.92). The model correctly classified 80% of participants as concussion/control at a 3.5-degree cutpoint.

CONCLUSIONS:

Adolescents with concussion demonstrated worse cervical spine proprioception than uninjured controls. Head repositioning accuracy may offer diagnostic utility for subacute concussion.

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article