We would like to thank the Canadian Institutes of Health Research (CIHR) who have provided funding for this research. Further, we would like to acknowledge Dr. Tim Taha and Dr. Scott Thomas from the University of Toronto for their assistance with the development of our protocol for the collection of resting state heart rate variability data.

설명 프로토콜은 수상 전 /베이스 라인 테스트 및 사후 부상 후속 평가를 포함하고 셋 스테이션을 사용하여 완료됩니다. 이 시험은 개별적으로 또는 각 스테이션에서 4 과목의 그룹이 한번에 완료 될 수있다. 주제는 아래에 나열된 순서대로 각 스테이션을 통해 진행합니다. 표 1의 시험 프로토콜 관리 일람표를 도시한다. 이 연구에 대한 윤리 승인 네덜란드 Bloorview 어린이 재활 병원에서 네덜란드 Bloorview 연구 윤리위원회로부터 얻은 것입니다. 모든 참가자 및 법적 보호자 전에 프로토콜 및 관련 데이터 수집을 완료하기 사전 동의 서명 된 제공합니다. 사전 상해 / 기준선 테스트 1 역 1 : 획득 사전 상해 인구 통계 학적 정보, 뇌진탕 증상 보고서 및 휴식 상태 심박수 가변성 (HRV) 데이터 <ol><li> (들) 테스트에 도착하면, 모든 장비는 기능입니다 보장 대상에 앞서평가 객실 테스트 것을 제대로 준비 보내고 불필요한 산만에서 무료입니다. </li><li> 부모와 주체의 동의를 검토 한 후, 측정 대상의 신장과 체중을 기록한다. 제대로 각 주제에 심장 박동 모니터 스트랩 시계를 설정합니다. </li><li> 인구 통계 학적 정보 양식을 관리하고 각 과목은 5 분 동안 앉아있는 동안 뇌진탕 증상 재고 (PCSI-C)의 어린이 버전을 사용 뇌진탕 증상 보고서를 수집합니다. </li><li> 각 주제는 깨끗한 소독 매트에 바닥에 누운 누​​워있다. ([On]으로 설정 RR 간격 기능) 상태 심박 변동 (HRV) 데이터를 쉬고 기록하기 위해 심장 박동 모니터를 켭니다. 각 과목 조용히 HR을 기록하는 동안 10 분 동안 얘기를하지 않고 부정사에 누워 남아있다. </li><li> 10 분 후, 주 HRV 데이터 수집 휴식 부정사 거짓말의 끝을 나타 내기 위해 시계에 무릎 버튼을 클릭합니다. 무릎 BU를 클릭 장착 위치로 돌아달라고 부탁합니다시계 tton 다시 상태 장착 HRV 데이터 수집 휴식의 시작을 나타냅니다. </li><li> 말없이 5 분 동안 앉아 위치를 유지 각 과목이 있습니다. 5 분 후, 세션과 휴식 상태 HRV 데이터 수집을 종료 시계 녹화 기능을 중지. 심장 박동 스트랩 시계를 벗어달라고 부탁합니다. </li></ol> 2 역 2 :인지 성능 데이터를 얻기 <ol><li> 마우스로 설정 개인 노트북과 개인 칸막이 각 과목에 앉아있다. 환경을 테스트하는 것은 산만에서 무료로 확인하십시오. </li><li> 직접 뇌진탕 후 평가 및인지 테스트 (영향), 신속하고 컴퓨터 신경 심리 평가 도구를 관리 (약 25 분 완료). </li></ol> 3 역 3 : 정적 균형, 그립 강도와 민첩성 / 모터 기술 데이터를 얻기 <ol><li> 감각 Integrati의 수정 된 임상 시험을 사용하여 정적 균형 평가를 관리휴대용 균형 시스템 잔액 (m-CTSIB)의에. 균형 시스템 forceplate에 서 있지만, 대상이 20 초 동안 눈을 뜨고 서 등 네 주문 조건을 완료; 20 초 동안 눈을 감고 서 서; 20 초 동안 인덱스 폼 패드에 눈을 뜨고 서; 눈으로 서하면 20 초 동안 인덱스 폼 패드에 마감했다. </li><li> 동력계를 사용하여 측정하고 오른쪽과 왼쪽 손을 모두 kg의 기록 핸드 그립 강도. 여전히 지배적 인 손으로 시작하여 각 손에 3 연속 시험을 완료 한 상태에서 각각의 주제에 대해 지배적 인 손을 기록합니다. 촬영 3 시험 중, 각 손에 최대 핸드 그립도 기록됩니다. 각 시험의 경우 대상은 3 초 중립 상지 위치를 유지 (손바닥이 몸과 손목을 중립에 직면, 몸 옆에 똑바로 직선 팔을 평행하게 서)을 위해 열심히 그들이 할 수있는 그립을 쥐어 짜기로 이야기된다. </li><li> 복도 나 체육관에서 최소 폭 2.5 m와 15m 긴 민첩성 / 모터를 관리수류탄 모듈 - ABI 챌린지 평가 (ABI-CA)를 사용하여 기술 평가. 모든 1m에 대한 포인트를 표시하는 직선에서 지상에 테이프를 놓는다. 다음과 같은 순서로 뇌진탕 모듈에서 제공하는 지침과 채점 기준의 이러한 여섯 테스트를 관리 할 수​​ 있습니다. <ol><li> 점프 - 잭 (타임) : <ol><li> 양쪽에 팔을 서서 팔, 다리와 &quot;X&quot;위치로 이동 한 다음 즉시 시작 위치로 다시 이동합니다. 15 초에서 행해질 수 얼마나 많은 횟수. </li></ol></li><li> 철탑 / 콘 장애물 코스를 실행 (타임) : <ol><li> 당신이 할 수있는 한 빨리하지만 안심 속도로 다시 끝 (10m)와에와 철탑에서 실행합니다. 철탑을 만지지 마십시오. 바로 마무리 라인을 통해 실행합니다. (3, 5, 7, 10m에 위치한 철탑) </li></ol></li><li> 이전 버전과의 연동 산책 (타임) : <ol><li> 줄 지어 트랙에서 5m에 직렬 패턴에서 뒤쪽으로 도보. 직렬 패턴은 oppos에 자신의 발 뒤꿈치에 닿아각 단계에 ITE 발가락. </li></ol></li><li> 수정 된 셔틀 런 (타임) : <ol><li> , 10m 선로를 따라 실행 과정의 단부에 공기 주머니를 픽업하고, 시작점에서 바구니에 공기 주머니를 배치하기 위해 다시 실행. 그들은 그들의 발과 함께 출발 선 그들이 바구니로 돌아마다 터치해야합니다. 모든 콩 주머니가 시작점 바구니까지이 세 번 반복한다. </li></ol></li><li> 기능과 아웃 (타임) : <ol><li> 40cm 떨어져있다 (경로)이 평행선 안에 두 발을 서있다. 다른 라인의 외부 이동 반대 다리 다음에 해당 라인의 외부에 한 발을 이동합니다. 첫 발은 두 번째 발 다음에, 내부에 반환됩니다. 사이클은 연속이어야하고 리드미컬 한 패션 (각 단계 사이에 동일한 시간)에 수행되어야하고, 앞으로 또는 뒤로 움직이지 않고 배를 반복합니다. </li></ol></li><li> 멀리뛰기 서 : 이동 앞으로 F로 두 발을 서에서당신이 할 수있는 3 초 동안 착륙을 동시에 소유 아칸소. 측정 및 먼 발바닥의 전면까지의 거리를 기록한다. 세 가지 시험은 가장 먼 거리를 달성하기 위해 제공됩니다 </li></ol></li></ol> (4) 후 상해 / 후속 테스트 <ol><li> 피사체가 뇌진탕 증상을 경험하는 동안 뇌진탕 후 데이터를 얻기 <ol><li> 피사체가 부상을 앓고 같은 날, 연구 직원은 전화 또는 이메일을 사용하여 주제별로 접촉된다. 연구 직원은 부상에 대한 임상 적 및 기능적 세부 사항을 기록합니다. </li><li> 즉시 (24 ~ 48 시간 게시물 부상) 뇌진탕 다음, 수집 : 상태 HRV 데이터를 (반복, 1.5-1.10을 1.3 단계) 휴식; 뇌진탕 증상 데이터 (단계를 반복 1.4); 균형 데이터 (단계를 반복 3.1). 테스트 기간 동안 증상이 악화되는 경우, 데이터 수집을 중지하고 나머지 될 수있다. </li><li> 상태 HRV 데이터 (반복, 1.5-1.10을 1.3 단계), 뇌진탕 증상 데이터 (단계를 반복 1.4)을 쉬고 수집을 계속하고,매주 뇌진탕 증상까지 균형 자료 (단계를 반복 3.1)을 해결했다. 테스트 기간 동안 증상이 악화되는 경우, 데이터 수집을 중지하고 나머지 될 수있다. </li><li> 연구 직원은 뇌진탕 증상 (PCSI-C를 사용하여) 해결시기를 결정하기 위해 전화로 주제를 매주 함께 다음과 같습니다. </li></ol></li></ol> 주제는 더 이상 뇌진탕 증상을 경험하는 동안 5 뇌진탕 후 데이터를 획득하지 <ol><li> 뇌진탕 증상이 해결 한 일주에서 후, 수집 : 상태 HRV 데이터를 (반복, 1.5-1.10을 1.3 단계) 휴식; 뇌진탕 증상 데이터 (단계를 반복 1.4); 인지 성능 데이터 (반복 2.1-2.2 단계); 균형 자료 (단계를 반복 3.1); 핸드 그립 데이터 (단계를 반복 3.2); 그리고, 민첩성 / 모터 기술 데이터 (단계를 반복 3.3). 테스트 기간 동안 증상이 악화되는 경우, 데이터 수집을 중지하고 나머지 될 수있다. </li><li> 해결 한 후 뇌진탕의 증상이 1 개월 후에서 5.1 단계를 반복합니다. 후 후 3 개월-concussion 증상이 단계를 반복 5.1 해결 된 것입니다. 이후 뇌진탕 증상을 해결 한 6 개월 후, 단계를 반복합니다 5.1. </li></ol>

<ol>
	<li>McCrory, P., Meeuwisse, W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Consensus+statement+on+Concussion+in+Sport+3rd+International+Conference+on+Concussion+in+Sport+held+in+Zurich,+November+2008.">Consensus statement on Concussion in Sport 3rd International Conference on Concussion in Sport held in Zurich, November 2008.</a> Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine. 19 (3), 185-200 (2009).</li><li>Kirkwood, M. W., Yeates, K. O., Wilson, P. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pediatric+sport-related+concussion:+a+review+of+the+clinical+management+of+an+oft-neglected+population.">Pediatric sport-related concussion: a review of the clinical management of an oft-neglected population.</a> Pediatrics. 117 (4), 1359-1371 (2006).</li><li>Khan, F., Baguley, I. J., Cameron, I. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=4:+Rehabilitation+after+traumatic+brain+injury.">4: Rehabilitation after traumatic brain injury.</a> The Medical journal of Australia. 178 (6), 290-295 (2003).</li><li>Langlois, J. A., Rutland-Brown, W., Wald, M. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+epidemiology+and+impact+of+traumatic+brain+injury:+a+brief+overview.">The epidemiology and impact of traumatic brain injury: a brief overview.</a> The Journal of head trauma rehabilitation. 21 (5), 375-378 (2006).</li><li>Browne, G. J., Lam, L. T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Concussive+head+injury+in+children+and+adolescents+related+to+sports+and+other+leisure+physical+activities.">Concussive head injury in children and adolescents related to sports and other leisure physical activities.</a> British Journal of Sports Medicine. 40 (2), 163-168 (2006).</li><li>Emery, C. A., Meeuwisse, W. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Injury+rates,+risk+factors,+and+mechanisms+of+injury+in+minor+hockey.">Injury rates, risk factors, and mechanisms of injury in minor hockey.</a> The American journal of sports medicine. 34 (12), 1960-1969 (2006).</li><li>Keightley, M., Reed, N., Green, S., Taha, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Age+and+competition+level+on+injuries+in+female+ice+hockey.">Age and competition level on injuries in female ice hockey.</a> International journal of sports medicine. 34 (8), 756-759 (2013).</li><li>McCrory, P., Meeuwisse, W. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Consensus+statement+on+concussion+in+sport:+the+4th+International+Conference+on+Concussion+in+Sport+held+in+Zurich,+November+2012.">Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012.</a> British journal of sports medicine. 47 (5), 250-258 (2013).</li><li>Krol, A. L., Mrazik, M., Naidu, D., Brooks, B. L., Iverson, G. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Assessment+of+symptoms+in+a+concussion+management+programme:+method+influences+outcome.">Assessment of symptoms in a concussion management programme: method influences outcome.</a> Brain injury: [BI. 25 (13-14), 1300-1305 (2011).</li><li>Williamson, I. J. S., Goodman, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Converging+evidence+for+the+under-reporting+of+concussions+in+youth+ice+hockey.">Converging evidence for the under-reporting of concussions in youth ice hockey.</a> British Journal of Sports Medicine. 40 (2), 128-132 (2006).</li><li>Cassidy, J. D., Carroll, L. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Incidence,+risk+factors+and+prevention+of+mild+traumatic+brain+injury:+results+of+the+WHO+Collaborating+Centre+Task+Force+on+Mild+Traumatic+Brain+Injury.">Incidence, risk factors and prevention of mild traumatic brain injury: results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury.</a> Journal of Rehabilitation Medicine: Official Journal of the UEMS European Board of Physical and Rehabilitation Medicine. (43 Suppl), 28-60 (2004).</li><li>Collins, M. W., Lovell, M. R., Iverson, G. L., Cantu, R. C., Maroon, J. C., Field, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cumulative+effects+of+concussion+in+high+school+athletes.">Cumulative effects of concussion in high school athletes.</a> Neurosurgery. 51 (5), 1175-1179 (2002).</li><li>Lovell, M. R., Collins, M. W., Iverson, G. L., Johnston, K. M., Bradley, J. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Grade+1+or+&#8220;ding&#8221;+concussions+in+high+school+athletes.">Grade 1 or &#8220;ding&#8221; concussions in high school athletes.</a> The American Journal of Sports Medicine. 32 (1), 47-54 (2004).</li><li>Guskiewicz, K. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Postural+stability+assessment+following+concussion:+one+piece+of+the+puzzle.">Postural stability assessment following concussion: one piece of the puzzle.</a> Clinical journal of sport medicine: official journal of the Canadian Academy of Sport Medicine. 11 (3), 182-189 (2001).</li><li>Guskiewicz, K. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Assessment+of+postural+stability+following+sport-related+concussion.">Assessment of postural stability following sport-related concussion.</a> Current Sports Medicine Reports. 2 (1), 24-30 (2003).</li><li>Reed, N., Taha, T., Tremblay, L., Monette, G., Keightley, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Concussion+and+strength+performance+in+youth+hockey+players.">Concussion and strength performance in youth hockey players.</a> Brain Injury. 26 (4-5), 766 (2012).</li><li>Chevignard, M., Toure, H., Brugel, D. G., Poirier, J., Laurent-Vannier, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+comprehensive+model+of+care+for+rehabilitation+of+children+with+acquired+brain+injuries.">A comprehensive model of care for rehabilitation of children with acquired brain injuries.</a> Child: care, health and development. 36 (1), 31-43 (2010).</li><li>Goldstein, B., Toweill, D., Lai, S., Sonnenthal, K., Kimberly, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Uncoupling+of+the+autonomic+and+cardiovascular+systems+in+acute+brain+injury.">Uncoupling of the autonomic and cardiovascular systems in acute brain injury.</a> The American journal of physiology. 275 (4 Pt 2), R1287-R1292 (1998).</li><li>Korpelainen, J. T., Huikuri, H. V., Sotaniemi, K. A., Myllyl&#228;, V. V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Abnormal+heart+rate+variability+reflecting+autonomic+dysfunction+in+brainstem+infarction.">Abnormal heart rate variability reflecting autonomic dysfunction in brainstem infarction.</a> Acta neurologica Scandinavica. 94 (5), 337-342 (1996).</li><li>Leddy, J. J., Kozlowski, K., Fung, M., Pendergast, D. R., Willer, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Regulatory+and+autoregulatory+physiological+dysfunction+as+a+primary+characteristic+of+post+concussion+syndrome:+implications+for+treatment.">Regulatory and autoregulatory physiological dysfunction as a primary characteristic of post concussion syndrome: implications for treatment.</a> NeuroRehabilitation. 22 (3), 199-205 (2007).</li><li>Covassin, T., Weiss, L., Powell, J., Womack, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+a+maximal+exercise+test+on+neurocognitive+function.">Effects of a maximal exercise test on neurocognitive function.</a> British journal of sports medicine. 41 (6), 370-374 (2007).</li><li>McCrory, P., Collie, A., Anderson, V., Davis, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Can+we+manage+sport+related+concussion+in+children+the+same+as+in+adults?.">Can we manage sport related concussion in children the same as in adults?.</a> British Journal of Sports Medicine. 38 (5), 516-519 (2004).</li></ol>

The authors have nothing to disclose.

이 프로토콜은 뇌진탕 다음과 청소년 운동 선수의 회복을 측정하는 멀티 모달 접근 방식을 제공합니다. 이 프로토콜의 중요한 기능은 / 기준선 부상을 미리하는 (주 심장 박동의 변화 등 휴식인지, 균형, 힘, 민첩성,) 성능 도메인의 넓은 범위에 걸쳐 뇌진탕 후 데이터의 비교입니다. 이 자료는 뇌진탕 다음 개별 청소년 운동 선수 사이에 복구를 표시하는 수단으로 역할을한다. 인지, 밸런스,...

수류탄 1 &quot;외상 역학적 힘에 의해 유도 된 뇌에 영향을 미치는 복합 병태 생리적 과정&quot;으로 정의 될 수 있고, 단기 및 장기 체세포,인지 및 / 또는 정서적 / 행동 적 증상이 발생할 수있다. 기능적으로, 뇌진탕 및 관련 증상은 일상 생활에서 하나의 참여에 상당한 영향을 미칠 3을 추구 할 수있다. 이것은 미국 내에서 1.6 3,800,000 뇌진탕 사이에 스포츠 참여 4의 결과로 매년 발생하는 것으로 추정되고있다. 스포츠에 참여 어린이와 청소년들에게 특정, 뇌진탕은 가장 일반적으로보고 된 상해 5-7 중 하나입니다. 일상 생활과 아동 및 청소년의 사이에 뇌진탕의 보급에 미칠 수있는 영향의 충격에도 불구하고, 청소년의 뇌가 성능 도메인의 다양한 걸쳐 충격에 반응하는 방식을보고 과학적인 자료의 부족이 남아있다. 베이스 라인 t불안감, 또는 복구 통보 후 부상 시험 점수에 대한 비교 벤치 마크와 같은 수상 전 테스트 점수의 사용, 청소년 스포츠 사회 내에서 성장 인기의 연습하고 유용한 추가 &quot;도움이 될 국제적으로 팔을 제안하고있다 뇌진탕의 관리시 정보 &quot;(P.3). 가장 (인지 적, 정서적 / 행동 체세포) 뇌진탕 후 증상의 다양한 성격을 표현하기 위해, 뇌진탕 후 회복의 평가 결과 다양한 조치를 포함하는 것이 중요합니다. 또한, 현재 뇌진탕 관리는 뇌진탕 증상의 주관적보고에 크게 의존하고있다. 이 주관적인 보고서의 유효성은 요소 구 다양한 영향을받을 수 있으며, 증상이 10, 11의 과소보고 및 복구 덜 정확하고 신뢰할 수있는 인덱스에 모두 발생할 수 있습니다. 그 결과, performan에서 측정 뇌진탕 후 회복 방법을 탐구하는 중요한 필요가있다객관적이고 민감한 둘 다 CE 도메인. 그것은 그인지, 밸런스, 힘을 증명되었다과 민첩성은 뇌진탕과 뇌 손상 12-17 다음과 청소년에 손상 될 수 있습니다. 본 시험 프로토콜 내에 포함될 대책 뇌진탕 다음 이들 도메인에 걸쳐 복구에 대한 통찰력을 제공하기 위해 일반적 뇌진탕 관리에 집중 임상 걸쳐 사용되는 임상 검증 테스트 도구의 사용을 포함하도록 선택되었다. 또한, 더 많은 탐색 관점에서 휴식 상태 HRV는 sympathovagal 18,19 밸런스의 정확한 측정으로 알 수있다. 교감 시스템 토닉 억제 제어하는​​ 동안 건강한 인구에서 sympathovagal 균형, 휴식 지배적 인 부교감 시스템으로 정의됩니다. 이 때문에 생리적 스트레스, 그 후 뇌진탕을 가설, 두 시스템 사이의 불균형이 존재하고 상태를 쉬고의 과다로 전환 할 수 있습니다교감 및 부교감 시스템 (20)의 시스템 hypoactivity. 본 연구의 프로토콜의 목적은 뇌진탕 다음과 같은 복구보다, 전체적인 객관적이고 정확한 이해를 얻기 위해 청소년 운동 선수 (세 10~18년) 사이에 사전 및 사후 뇌진탕 성능의 멀티 모달 평가를 수행하는 것입니다. 이 연구는 개발과 어린이와 청소년들에게 특정 뇌진탕 관리 및 재활 프로토콜의 전달에 대한 통찰력을 제공하는 것을 목표로하고있다.

<table border="0" cellpadding="0" cellspacing="0" width="584">
	<tbody>
		<tr>
			<td>Name of Reagent/ Equipment</td>
			<td>Company</td>
			<td>Catalog Number</td>
			<td>Comments/Description</td>
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			<td>Scale</td>
			<td>Weight Watchers: Conair&#160;</td>
			<td>WW30WB</td>
			<td></td>
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			<td>Measuring Tape</td>
			<td>Hi-Viz Lufkin</td>
			<td>HVC716CME</td>
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			<td>Heart Rate Monitor (Chest Strap and Watch)</td>
			<td>Polar</td>
			<td>RS800CX GPS</td>
			<td></td>
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			<td>Exercise/Yoga Mat</td>
			<td>Pur Athletics</td>
			<td>WTE10126</td>
			<td></td>
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			<td>Sportline Stopwatch (Model 228)</td>
			<td>EB Sport Group</td>
			<td>#2787</td>
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			<td>Laptop - MacBook Pro</td>
			<td>Apple</td>
			<td>A1278</td>
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			<td>Computerized Cognitive Assessment- Immediate Post-Concussion Assessment and Cognitive Task</td>
			<td>ImPACT Application&#39;s Inc.&#160;</td>
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			<td>Hand Grip Dynamometer</td>
			<td>Sammons Preston- Smedley-Type</td>
			<td>5032P</td>
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			<td>BioSway</td>
			<td>Biodex Medical Supplies Inc.&#160;</td>
			<td>950-510</td>
			<td></td>
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		<tr>
			<td>Painter&#39;s Mate Green Tape</td>
			<td>ShurTech Brands LLC</td>
			<td>#49462</td>
			<td></td>
		</tr>
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			<td>Pylons/Cones (12&#34;)</td>
			<td>Canadian Tire</td>
			<td>84-295-4</td>
			<td></td>
		</tr>
		<tr>
			<td>Basket</td>
			<td>Canadian Tire</td>
			<td>42-9919-2</td>
			<td></td>
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			<td>Bean Bags</td>
			<td>Eastpoint/Go Gater</td>
			<td>1-1-16392</td>
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	</tbody>
</table>

a multi-modal approach to assessing recovery in youth athletes following concussion

수류탄은 스포츠 참여에 관여 어린이와 청소년 사이에 가장 일반적으로보고 된 부상 중 하나입니다. 뇌진탕 후, 청소년, 일상 활동과 관심의 추구 (예를 들면, 학교, 스포츠, 직장에서 자신의 참여에 상당한 영향을 미칠 수있는 단기 및 장기 신경 행동 증상의 범위 (인지 적, 정서적 신체적 / 행동)을 체험 할 수있는 가족 / 사회 생활 등). 그럼에도 불구하고, 청소년 스포츠 인구 내에서 뇌진탕을 탐험에서 특별히 목표로 임상 중심의 연구 paucity 및 복구를 측정하는보다 구체적으로, 멀티 모달 접근 방법이 남아있다. 이 문서에서는 뇌진탕 다음과 청소년 운동 선수 사이에 복구를 측정하는 새로운 멀티 모달 접근 방식에 대한 개요를 제공합니다. 제시된 방법은 도메인에 걸쳐 다양한 성능을 평가하기 위해 사전 부상 / 기준선 시험 및 사후 부상 모두 / 후속 시험의 사용을 포함한다 (포스트 concus시온 증상,인지, 균형, 힘, 민첩성 / 모터 기술과 휴식 상태 심박수 변동). 본 연구의 목적은 청소년 선수 (세 10~18년)에서 뇌진탕 다음과 같은 복구에 대한보다 객관적이고 정확한 이해를 얻을 것입니다. 본 연구에서 연구 결과는 청소년 스포츠 커뮤니티 관리 및 재활 특정를 충격하는 개발 및 개선 방법의 사용을 알리는 데 도움이 될 수 있습니다.

제시된 프로토콜은 지속적으로 조사합니다. 표 1 프로토콜의 시험 관리 일정을 보여줍니다. 대표 결과는 청소년의 충격에 의해 영향을받을 것으로 알려진 성능 도메인의 다양한 걸쳐 기준 / 사전 부상과 뇌진탕 후 데이터를 수집의 타당성을 입증되게됩니다. 선정 결과 측정에서 복구 궤적을 보여주기 위해 제공되는 프로토콜의 모든 단계를 완료 뇌진탕 청소년의 단일 케이스. ?...

Watch this Scientific Journal Video about A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion at JoVE.com

A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion

This article provides an overview of a multi-modal approach to assessing recovery following concussion in youth athletes. The described protocol uses pre- and post-concussion assessment of performance across a wide variety of domains and can inform the development of improved concussion rehabilitation protocols specific to the youth sport community.

수류탄에 따라 청소년 운동 선수의 평가 복구에 멀티 모달 접근

Concussion is one of the most commonly reported injuries amongst children and youth involved in sport participation. Following a concussion, youth can ...

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Research

JoVE Journal

Medicine

13.3K 조회수.  Holland Bloorview Kids Rehabilitation Hospital. This article provides an overview of a multi-modal approach to assessing recovery following concussion in youth athletes. The described protocol uses pre- and post-concussion assessment of performance across a wide variety of domains and can inform the development of improved concussion rehabilitation protocols specific to the youth sport community.

비디오: A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion

An Investigation of the Effects of Sports-related Concussion in Youth Using Functional Magnetic Resonance Imaging and the Head Impact Telemetry System

One of the most commonly reported injuries in children who participate in sports is concussion or mild traumatic brain injury (mTBI)1. Children and youth involved in organized sports such as competitive hockey are nearly six times more likely to suffer a severe concussion compared to children involved in other leisure physical activities2. While the most common cognitive sequelae of mTBI appear similar for children and adults, the recovery profile and breadth of consequences in children remains largely unknown2, as does the influence of pre-injury characteristics (e.g. gender) and injury details (e.g. magnitude and direction of impact) on long-term outcomes. Competitive sports, such as hockey, allow the rare opportunity to utilize a pre-post design to obtain pre-injury data before concussion occurs on youth characteristics and functioning and to relate this to outcome following injury. Our primary goals are to refine pediatric concussion diagnosis and management based on research evidence that is specific to children and youth. To do this we use new, multi-modal and integrative approaches that will:
 1.Evaluate the immediate effects of head trauma in youth 
2.Monitor the resolution of post-concussion symptoms (PCS) and cognitive performance during recovery 
3.Utilize new methods to verify brain injury and recovery
To achieve our goals, we have implemented the Head Impact Telemetry (HIT) System. (Simbex; Lebanon, NH, USA). This system equips commercially available Easton S9 hockey helmets (Easton-Bell Sports; Van Nuys, CA, USA) with single-axis accelerometers designed to measure real-time head accelerations during contact sport participation 3 - 5. By using telemetric technology, the magnitude of acceleration and location of all head impacts during sport participation can be objectively detected and recorded. We also use functional magnetic resonance imaging (fMRI) to localize and assess changes in neural activity specifically in the medial temporal and frontal lobes during the performance of cognitive tasks, since those are the cerebral regions most sensitive to concussive head injury 6. Finally, we are acquiring structural imaging data sensitive to damage in brain white matter.

This article provides an overview of a multi-modal approach to mild traumatic brain injury diagnosis and recovery in youth. This approach combines neuropsychological testing with functional magnetic resonance imaging and the Head Impact Telemetry System to monitor the relationship between head impacts and brain activity during cognitive testing.

기능성 자기 공명 이미징 및 머리 충격 텔레 메 트리 시스템을 사용하는 청소년의 스포츠 관련 뇌진탕의 효과 조사

One of the most commonly reported injuries in children who participate in sports is concussion or mild traumatic brain injury (mTBI)1. Children and youth ...

연구

의학

Assessing Teratogenic Changes in a Zebrafish Model of Fetal Alcohol Exposure

Fetal alcohol syndrome (FAS) is a severe manifestation of embryonic exposure to ethanol. It presents with characteristic defects to the face and organs, including mental retardation due to disordered and damaged brain development. Fetal alcohol spectrum disorder (FASD) is a term used to cover a continuum of birth defects that occur due to maternal alcohol consumption, and occurs in approximately 4% of children born in the United States. With 50% of child-bearing age women reporting consumption of alcohol, and half of all pregnancies being unplanned, unintentional exposure is a continuing issue2. In order to best understand the damage produced by ethanol, plus produce a model with which to test potential interventions, we developed a model of developmental ethanol exposure using the zebrafish embryo. Zebrafish are ideal for this kind of teratogen study3-8. Each pair lays hundreds of eggs, which can then be collected without harming the adult fish. The zebrafish embryo is transparent and can be readily imaged with any number of stains. Analysis of these embryos after exposure to ethanol at different doses and times of duration and application shows that the gross developmental defects produced by ethanol are consistent with the human birth defect. Described here are the basic techniques used to study and manipulate the zebrafish FAS model.

In order to understand the molecular mechanisms of the ethanol-induced developmental damage, we have developed a zebrafish model of ethanol exposure and are exploring the physical, cellular, and genetic alterations that occur after ethanol exposure1. We then seek to find potential interventions and rapidly test them in this animal model.

태아 알코올 노출의 Zebrafish 모델에서 Teratogenic 변경 사항 평가

Fetal alcohol syndrome (FAS) is a severe manifestation of embryonic exposure to ethanol. It presents with characteristic defects to the face and organs, ...

Multi-modal Imaging of Angiogenesis in a Nude Rat Model of Breast Cancer Bone Metastasis Using Magnetic Resonance Imaging, Volumetric Computed Tomography and Ultrasound

Angiogenesis is an essential feature of cancer growth and metastasis formation. In bone metastasis, angiogenic factors are pivotal for tumor cell proliferation in the bone marrow cavity as well as for interaction of tumor and bone cells resulting in local bone destruction. Our aim was to develop a model of experimental bone metastasis that allows in vivo assessment of angiogenesis in skeletal lesions using non-invasive imaging techniques.
For this purpose, we injected 105 MDA-MB-231 human breast cancer cells into the superficial epigastric artery, which precludes the growth of metastases in body areas other than the respective hind leg1. Following 25-30 days after tumor cell inoculation, site-specific bone metastases develop, restricted to the distal femur, proximal tibia and proximal fibula1. Morphological and functional aspects of angiogenesis can be investigated longitudinally in bone metastases using magnetic resonance imaging (MRI), volumetric computed tomography (VCT) and ultrasound (US).
MRI displays morphologic information on the soft tissue part of bone metastases that is initially confined to the bone marrow cavity and subsequently exceeds cortical bone while progressing. Using dynamic contrast-enhanced MRI (DCE-MRI) functional data including regional blood volume, perfusion and vessel permeability can be obtained and quantified2-4. Bone destruction is captured in high resolution using morphological VCT imaging. Complementary to MRI findings, osteolytic lesions can be located adjacent to sites of intramedullary tumor growth. After contrast agent application, VCT angiography reveals the macrovessel architecture in bone metastases in high resolution, and DCE-VCT enables insight in the microcirculation of these lesions5,6. US is applicable to assess morphological and functional features from skeletal lesions due to local osteolysis of cortical bone. Using B-mode and Doppler techniques, structure and perfusion of the soft tissue metastases can be evaluated, respectively. DCE-US allows for real-time imaging of vascularization in bone metastases after injection of microbubbles7.
In conclusion, in a model of site-specific breast cancer bone metastases multi-modal imaging techniques including MRI, VCT and US offer complementary information on morphology and functional parameters of angiogenesis in these skeletal lesions.

In the pathogenesis of bone metastasis, angiogenesis is a crucial process and therefore represents a target for imaging and therapy. Here, we present a rat model of site-specific breast cancer bone metastasis and describe strategies to non-invasively image angiogenesis in vivo using magnetic resonance imaging, volumetric computed tomography and ultrasound.

자기 공명 영상, 체적 계산의 Tomography 및 초음파를 이용한 유방암의 뼈 전이의 누드 쥐 모델에서 Angiogenesis의 멀티 모달 이미징

Angiogenesis is an essential feature of cancer growth and metastasis formation. In bone metastasis, angiogenic factors are pivotal for tumor cell ...

A Neuroscientific Approach to the Examination of Concussions in Student-Athletes

Concussions are occurring at alarming rates in the United States and have become a serious public health concern. The CDC estimates that 1.6 to 3.8 million concussions occur in sports and recreational activities annually. Concussion as defined by the 2013 Concussion Consensus Statement &#8220;may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an &#8216;impulsive&#8217; force transmitted to the head.&#8221; Concussions leave the individual with both short- and long-term effects. The short-term effects of sport related concussions may include changes in playing ability, confusion, memory disturbance, the loss of consciousness, slowing of reaction time, loss of coordination, headaches, dizziness, vomiting, changes in sleep patterns and mood changes. These symptoms typically resolve in a matter of days. However, while some individuals recover from a single concussion rather quickly, many experience lingering effects that can last for weeks or months. The factors related to concussion susceptibility and the subsequent recovery times are not well known or understood at this time. Several factors have been suggested and they include the individual&#8217;s concussion history, the severity of the initial injury, history of migraines, history of learning disabilities, history of psychiatric comorbidities, and possibly, genetic factors. Many studies have individually investigated certain factors both the short-term and long-term effects of concussions, recovery time course, susceptibility and recovery. What has not been clearly established is an effective multifaceted approach to concussion evaluation that would yield valuable information related to the etiology, functional changes, and recovery. The purpose of this manuscript is to show one such multifaceted approached which examines concussions using computerized neurocognitive testing, event related potentials, somatosensory perceptual responses, balance assessment, gait assessment and genetic testing.

There is great variability in an individual&#8217;s risk for concussion and their corresponding recovery. A multifaceted approach to concussion evaluation is warranted; including baseline testing of athletes before participation in sport and timely evaluation post injury. The goal of this protocol is to provide an appropriate multifaceted approach to examine concussions.

학생 운동 선수에 진탕의 시험에 대한 신경 과학적 접근

Concussions are occurring at alarming rates in the United States and have become a serious public health concern. The CDC estimates that 1.6 to 3.8 ...

Non-invasive Assessments of Subjective and Objective Recovery Characteristics Following an Exhaustive Jump Protocol

Fast recovery after strenuous exercise is important in sports and is often studied via cryotherapy applications. Cryotherapy has a significant vasoconstrictive effect, which seems to be the leading factor in its effectiveness. The resulting enhanced recovery can be measured by using both objective and subjective parameters. Two commonly measured subjective characteristics of recovery are delayed-onset muscle soreness (DOMS) and ratings of perceived exertion (RPE). Two important objective recovery characteristics are countermovement jump (CMJ) performance and peak power output (PPO). Here, we provide a detailed protocol to induce muscular exhaustion of the frontal thighs with a self-paced, 3 x 30 countermovement jump protocol (30-s rest between each set). This randomized controlled trial protocol explains how to perform local cryotherapy cuff application (+ 8 &#176;C for 20 min) and thermoneutral cuff application (+ 32 &#176;C for 20 min) on both thighs as two possible post-exercise recovery modalities. Finally, we provide a non-invasive protocol to measure the effects of these two recovery modalities on subjective (i.e., DOMS of both frontal thighs and RPE) and objective recovery (i.e., CMJ and PPO) characteristics 24, 48, and 72 h post-application. The advantage of this method is that it provides a tool for researchers or coaches to induce muscular exhaustion, without using any expensive devices; to implement local cooling strategies; and to measure both subjective and objective recovery, without using invasive methods. Limitations of this protocol are that the 30 s rest period between sets is very short, and the cardiovascular demand is very high. Future studies may find the assessment of maximum voluntary contractions to be a more sensitive assessment of muscular exhaustion compared to CMJs.

This protocol describes the procedure for non-invasive recovery assessments during a 72 h recovery period. This protocol induces muscular exhaustion of the frontal thighs using countermovement jumps and uses either local cold-cuff or thermoneutral-cuff application as a recovery modality.

철저한 점프 프로토콜에 따른 주관적 및 객관적인 복구 특성의 비 침습적 평가

Fast recovery after strenuous exercise is important in sports and is often studied via cryotherapy applications. Cryotherapy has a significant ...

A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition

Limited evidence exists to precisely estimate efficacy and safety differences between parenteral nutrition (PN) prepared using olive-oil-based three-chamber bags (3CBs) and soybean-oil-based compounded bags (CoBs) in hospitalized adult patients. We designed a multicenter, randomized, prospective, open-label, noninferiority protocol to compare the efficacy, safety, and distribution of olive-oil-based 3CBs and soybean-oil-based CoB formulations in adult Chinese patients requiring PN during surgical intervention. Subjects were randomized to receive either one of the study treatments using an interactive voice or web-based recognition system in accordance with the randomization code. Randomization was further stratified based on the study site and surgical category. Both treatment groups received similar amounts of calories and protein. In addition, the two study treatments contained a similar composition of the amino-acid component. The only difference between the two PN formulations was the lipid constitution. The duration of administration of study treatments was a minimum of 5 days up to a maximum of 14 days after the surgical procedure. The primary efficacy endpoint was serum prealbumin levels on day 5 of the study. Noninferiority was proved if the anti-log of the lower bound of the 95% confidence interval (CI) of the treatment difference was at least 0.80. Other efficacy measures included treatment preparation time; duration to achieve tolerability of oral nutrition; associated infectious complications; length of hospitalization; and laboratory assessment of markers of nutrition, inflammation, metabolism, and oxidative stress. A total of 458 patients were enrolled in the study. The results showed that olive-oil-based 3CBs were non-inferior to soybean-based CoBs, besides being well tolerated. The infection rate was found to be significantly lower in the olive-oil-based 3CB group. Thus, this study may be used as a reference for future research on lipid emulsion and 3CBs.

Here, we present a protocol for a study comparing the efficacy, safety, and delivery of olive-oil-based 3CB and soybean-oil-based CoB formulations in adults requiring parenteral nutrition. The results revealed that olive-oil-based 3CBs is non-inferior and well tolerated compared to soybean formulations.

Limited evidence exists to precisely estimate efficacy and safety differences between parenteral nutrition (PN) prepared using olive-oil-based ...

Autonomic Function Following Concussion in Youth Athletes: An Exploration of Heart Rate Variability Using 24-hour Recording Methodology

Participation in organized sports makes a significant contribution to youth development, but places youth at a higher risk for sustaining a concussion. To date, return-to-activity decision-making has been anchored in the monitoring of self-reported concussion symptoms and neurocognitive testing. However, multi-modal assessments that corroborate objective physiological measures with traditional subjective symptom reporting are needed and can be valuable. Heart rate variability (HRV) is a non-invasive physiological indicator of the autonomic nervous system, capturing the reciprocal interplay between the sympathetic and parasympathetic nervous systems. There is a dearth of literature exploring the effect of concussion on HRV in youth athletes, and developmental differences preclude the application of adult findings to a pediatric population. Further, the current state of HRV methodology has primarily included short-term (5-15 min) recordings, by using resting state or short-term physical exertion testing to elucidate changes following concussion. The novelty in utilizing a 24 h&#160;recording methodology is that it has the potential to capture natural variation in autonomic function, directly related to the activities a youth athlete performs on a regular basis. Within a prospective, longitudinal research setting, this novel approach to quantifying autonomic function can provide important information regarding the recovery trajectory, alongside traditional self-report symptom measures. Our objectives regarding a 24 h recording methodology were to (1) evaluate the physiological effects of a concussion in youth athletes, and (2) describe the trajectory of physiological change, while considering the resolution of self-reported post-concussion symptoms. To achieve these objectives, non-invasive sensor technology was implemented. The raw beat-to-beat time intervals captured can be transformed to derive time domain and frequency domain measures, which reflect an individual&#39;s ability to adapt and be flexible to their ever-changing environment. By using non-invasive heart rate technology, autonomic function can be quantified outside of a traditional controlled research setting.

We demonstrate a 24 h heart rate recording methodology to evaluate the influence of concussion across the recovery trajectory in youth athletes, within an ecologically valid context.

자율 기능 청소년 선수에 뇌 진 탕을 다음: 24 시간 녹화 방법론을 사용 하 여 심장 박동의 변화 탐구

Participation in organized sports makes a significant contribution to youth development, but places youth at a higher risk for sustaining a concussion. To ...

A Novel Approach to Monitoring Graft Neovascularization in the Human Gingiva

Laser speckle contrast imaging (LSCI) is a novel method for measuring superficial blood perfusion over large areas. Since it is non-invasive and avoids direct contact with the measured area, it is suitable for monitoring blood flow changes during wound healing in human patients. Vestibuloplasty is periodontal surgery to the oral vestibule, aiming to restore vestibular depth with simultaneous enlargement of the keratinized gingiva. In this special clinical case, a split thickness flap was elevated at the first upper premolar and a xenogenic collagen matrix was adapted to the resulting recipient bed. LSCI was used to monitor the re- and neovascularization of the graft and the surrounding mucosa for one year. A protocol is introduced for the correct adjustment of microcirculation measurement in the oral mucosa, highlighting difficulties and possible failures.
The clinical case study presented demonstrated that &#8212; following the appropriate protocol &#8212; LSCI is a suitable and reliable method for following up microcirculation in a healing wound in the human oral mucosa and gives useful information on graft integration.

This study introduces a protocol for measuring microcirculation in human oral mucosa by laser speckle contrast imaging. The monitoring of wound healing after vestibuloplasty combined with a xenogenic collagen graft is presented on a clinical case.

새로운 접근 방식을 접목 Neovascularization 인간의 Gingiva에 모니터링

Laser speckle contrast imaging (LSCI) is a novel method for measuring superficial blood perfusion over large areas. Since it is non-invasive and avoids ...

Multi-Modal Home Sleep Monitoring in Older Adults

The gold standard for sleep monitoring is attended in-lab polysomnography; however, this method may be cost-prohibitive and inconvenient for patients and research participants. Home sleep testing has gained momentum in the field of sleep medicine due to its convenience and lower cost, as well as being more naturalistic. The accuracy and quality of home sleep testing, however, may be variable because studies are not monitored by sleep technologists. There has been some success in improving the accuracy of home sleep studies by having trained sleep technicians assist participants inside their homes with putting on the devices, but this can be intrusive and time-consuming for those involved. In this protocol, participants undergo at-home sleep monitoring with multiple devices: 1) a single-channel EEG device; 2) a home sleep test for sleep-disordered breathing and periodic limb movements; 3) actigraphy; and 4) sleep logs. A major challenge of this study is obtaining high-quality sleep monitoring data on the first attempt in order to minimize participant burden. This protocol describes the implementation of educational manuals with step-by-step instructions and photos. The goal is to improve the quality of home sleep testing.

Here, we present a protocol to improve the quality of data from home sleep testing by providing a method to enhance instructions through a structured participant visit. This protocol includes the implementation of a step-by-step educational manual with photos to ensure proper placement of equipment.

멀티 모달 집 수 면 노인에 모니터링

The gold standard for sleep monitoring is attended in-lab polysomnography; however, this method may be cost-prohibitive and inconvenient for patients and ...

Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion

The evidence-informed standardization of care along disease lines is recommended to improve outcomes and reduce healthcare costs. The aim of this project is to 1) describe the development and implementation of the Concussion Carepath, 2) demonstrate the process of integrating technology in the form of a mobile application to enable the carepath and guide clinical decision-making, and 3) present data on the utility of the C3 app in facilitating decision-making throughout the injury recovery process. A multi-disciplinary team of experts in concussion care was formed to develop an evidence-informed algorithm, outlining best practices for the clinical management of concussion along three phases of recovery &#8211; acute, subacute, and post-concussive. A custom mobile application, the Cleveland Clinic Concussion (C3) app was developed and validated to provide a platform for the systematic collection of objective, biomechanical outcomes and to provide guidance in clinical decision-making in the field and clinical environments. The Cleveland Clinic Concussion app included an electronic incident report, assessment modules to measure important aspects of cognitive and motor function, and a return to play module to systematically document the six phases of post-injury rehabilitation. The assessment modules served as qualifiers within the carepath algorithm, driving referral for specialty services as indicated. Overall, the carepath coupled with the C3 app functioned in unison to facilitate communication among the interdisciplinary team, prevent stagnant care, and drive patients to the right provider at the right time for efficient and effective clinical management.

A multidisciplinary carepath to standardize disparate concussion care was developed and implemented at the Cleveland Clinic. The Cleveland Clinic Concussion (C3) mobile application was used to enable the carepath through biomechanical outcomes characterizing cognitive and motor function. Patient outcomes improved while cost of care was reduced following implementation.

개발 및 멀티-징계 기술의 구현 청소년과 뇌 진 탕과 어른에 대 한 관리 경로 강화

The evidence-informed standardization of care along disease lines is recommended to improve outcomes and reduce healthcare costs. The aim of this project ...