子供の脳震盪管理方針の変更が回復時間を改善 (A change in child concussion management policies led to improvements in recovery time)

2025-02-25 カナダ・コンコーディア大学

<関連情報>

• https://www.concordia.ca/news/stories/2025/02/25/a-change-in-child-concussion-management-policies-led-to-improvements-in-recovery-time-concordia-research-shows.html
• https://journals.humankinetics.com/view/journals/jsr/aop/article-10.1123-jsr.2024-0097/article-10.1123-jsr.2024-0097.xml

脳震盪管理方針の変更により、リハビリテーションサービスの早期開始が促進され、脳震盪の臨床的回復の結果が改善した A Concussion Management Policy Change Promoted Earlier Initiation of Rehabilitation Services and Improved Clinical Recovery Outcomes in Concussion

Elizabeth F. Teel,Danielle Dobney,Deborah Friedman,Lisa Grilli,Christine Beaulieu, andIsabelle J. Gagnon
Journal of Sport Rehabilitation  Published:11 Jan 2025
DOI:https://doi.org/10.1123/jsr.2024-0097

Abstract

Context: In line with emerging research, an interprofessional specialty concussion clinic instituted a policy change permitting earlier physiotherapy-based treatment entry. Our objective was to determine the effect of this policy change on concussion recovery outcomes. Design: Secondary analysis of prospectively collected clinical data. Methods: 600 youth with concussion were included. Active rehabilitation was initiated ≥4 weeks (prepolicy) or ≥2 weeks (postpolicy) postconcussion based on institutional policy. Cox proportional hazard models, linear mixed models, and chi-square analyses were conducted. Results: The postpolicy group (median = 22 d [interquartile range: 17–27]) started treatment earlier than the prepolicy group (median = 26 d [interquartile range: 24–30], P < .001). Length of episode of care (χ²(1) = 11.55, P < .001, odds ratios = 1.49; 95% confidence interval, 1.19–1.88); rehabilitation (χ²(1) = 9.47, P = .002, odds ratios = 1.73, 95% confidence interval, 1.22–2.45]); and total recovery (χ²(1) = 11.53, P < .001, odds ratios = 1.49; 95% confidence interval, 1.18–1.88) were reduced in patients postpolicy change. A significant interaction effect was found for total postinjury symptom (F_2,320 = 3.59, P = .03) and symptom change scores (F_2,315 = 5.17, P = .006), with the postpolicy group having faster symptom resolution over time. No group differences were observed for persisting symptoms. Conclusions: Earlier rehabilitation initiation occurred as intended following an institutional policy change, which had small, but significant, effects on recovery outcomes in youth with concussion. Health care providers should adopt policies to encourage early active rehabilitation services after concussion.