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.

Açıklanan protokol öncesi yaralanma / temel test ve post-yaralanma takip değerlendirmesini içerir ve üç istasyonlarını kullanarak tamamlandı. Bu test bireysel olarak ya da her istasyonda dört konularda gruplar halinde bir seferde tamamlanabilir. Konular aşağıda listelenen sırayla her istasyonu aracılığıyla devam edin. Tablo 1 protokolün test yönetimi programı göstermektedir. Bu araştırma için Etik onay Hollanda Bloorview Çocuklar Rehabilitasyon Hastanesi&#39;nde Hollanda Bloorview Araştırma Etik Kurulu&#39;ndan elde edilmiştir. Tüm katılımcılar ve onların yasal vasileri öncesinde protokol ve ilgili veri toplama tamamlamadan onam imzalı sağlarlar. Ön yaralanma / Baseline Test 1. İstasyon 1: alma Öncesi yaralanma Demografik Bilgiler, post-sarsıntı Belirti Raporu ve Dinlenme Devlet Kalp hızı değişkenliği (HRV) Veri <ol><li> (Ler) testleri için gelen, tüm ekipman fonksiyonu sağlamak tabi öncedeğerlendirme odaları test için ve düzgün ve hazır ing gereksiz dikkat dağıtıcı ücretsizdir. </li><li> Ebeveyn ve gönüllü olur inceledikten sonra, ölçmek ve kişinin boy ve ağırlığı kaydetmek. Düzgün, her konuda kalp hızı monitörü askıları ve saatler ayarlayın. </li><li> Demografik bilgi formu, yönetmek ve her konu 5 dakika boyunca oturmuş ise post-Beyin sarsıntısı Belirti Envanteri (PCSI-C) Çocuk sürümünü kullanarak sarsıntı sonrası semptom rapor toplamak. </li><li> Her konu temiz ayıklanmış hasır üzerinde yere sırtüstü yatıyordu var. ([On] olarak ayarlanmış RR aralığı fonksiyonu ile) devlet kalp hızı değişkenliği (KHD) verileri istirahat kaydetmek için kalp hızı monitörleri açın. Her konu sessizce HR kayıt sırasında 10 dakika boyunca konuşmadan sırtüstü yatarken kalır mı. </li><li> 10 dakika sonra, devlet KHD veri toplama istirahat sırtüstü Yalanın sona erdiğini belirtmek için nöbet kucak düğmesini tıklatın. Tur met tıklayın, oturmuş bir pozisyona dönmek için konuyu isteyinseyretmek tton tekrar devlet oturmuş KHD veri toplama istirahat başladığını belirtir. </li><li> Konuşmadan 5 dakika boyunca oturur pozisyonda kalması her konuyu var. 5 dakika sonra, oturum ve dinlenme devlet KHD veri toplama sona erdirmek için saat kayıt işlevini durdurmak. Kalp hızı kayışı ve saatler çıkarmak için konuyu isteyin. </li></ol> 2. İstasyon 2: Bilişsel Performans Veri Edinme <ol><li> Bir fare ile kurulmuş bir kişisel dizüstü bilgisayar ile bireysel dolabında her konu oturmak var. Ortamı test oyalama ücretsiz olduğundan emin olun. </li><li> Hemen Post-sarsıntı Değerlendirme ve Bilişsel Test (IMPACT), hızlı ve bilgisayarlı nöropsikolojik değerlendirme aracı yönetme (yaklaşık 25 dk tamamlamak için). </li></ol> 3. İstasyon 3: Statik denge, tutma gücü ve çeviklik / Motor Becerileri Veri Edinme <ol><li> Duyu INTEGRATI değiştirilmiş Klinik Testi kullanılarak statik denge değerlendirmesi yönetmetaşınabilir denge sistemi üzerine Dengesi (m-CTSIB) on. Denge sistemi forceplate üzerinde dururken, konu 20 saniye boyunca açık gözlerle duran içerir dört sıralı koşullarını tamamlar; 20 saniye için kapalı gözlerle ayakta; 20 sn için endekslenmiş köpük pedi açık gözlerle ayakta; ve gözleri ile ayakta 20 saniye boyunca endeksli köpük ped kapanmıştır. </li><li> Bir Dinamometre kullanarak, ölçmek ve sağ ve sol elleri hem kg rekor el kavrama gücü. Hala dominant elin başlayarak her el için art arda 3 denemeler tamamladıktan ederken, her konu için baskın elini kaydedin. Alınan 3 çalışmaların dışında, her taraftan maksimum el kavrama da kaydedilecektir. Her deneme için konu 3 sn nötr üst ekstremite pozisyonu tutulması (palmiye gövde ve bilek nötr bakan, bedenin yanında, dik düz kol paralel duran) için de zor onlar gibi kavrama sıkmak için söylenir. </li><li> Bir koridorda veya spor salonunda en az genişliğinde 2,5 m ve 15 m uzunluğunda çeviklik / motoru yönetmekBeyin sarsıntısı Modülü - ABI-Mücadelesi Değerlendirme (ABI-CA) kullanılarak becerilerinin değerlendirilmesi. Her 1 m için puan işaretleme düz bir çizgide yere bandı yatıyordu. Aşağıdaki sırayla sarsıntı modülünde verilen kurallar ve puanlama kriterleri aşağıdaki bu 6 testleri yönetmek. <ol><li> Atlama-krikolar (Zamanlı): <ol><li> Senin kenarlarında silah Stand ve kol ve bacakları ile bir &quot;X&quot; konumda içine atlamak ve daha sonra anında başlangıç ​​pozisyonuna geri atlamak. 15 saniye içinde yapılabilir kaç sayın. </li></ol></li><li> Pilon / koni engel ders çalışma (Süreli): <ol><li> Olabildiğince hızlı olarak ama güvenli hissediyorum bir hızda geri sonunda (10 m) ve ve dikmesi tükendi. Direkler dokunmayın. Düz bitiş çizgisine koşuyoruz. (3, 5, 7, 10 m bulunan Pilonlar) </li></ol></li><li> Geriye tandem yürüyüş (Süreli): <ol><li> Kaplı pist üzerinde, 5 m için tandem desen geriye yürümek. Tandem desen kendi oPPos onların topuk dokunuyorHer adımda ite ayak. </li></ol></li><li> Modifiye mekik koşusu (Süreli): <ol><li> , 10 m iz boyunca çalıştırın dersin sonunda Minder pick up, ve başlangıç ​​noktasında bir sepet içinde puf yerleştirmek için geri çalıştırın. Onlar ayak başlangıç ​​fanyonundan onlar sepet dönmek her zaman temas etmelidir. Tüm beanbags başlangıç ​​noktasında sepetin içinde kadar bu üç kez tekrarlayın. </li></ol></li><li> Ins ve çıkışları (Süreli): <ol><li> 40 cm arayla (yolu) iki paralel çizgi içinde iki ayaklı stand. Diğer hattının dışında hareket karşısında bacak ardından gelen çizginin dışında bir ayak taşıyın. Birinci ayak sonra, ikinci ayağın, ardından iç döndürülür. Döngüleri ardışık olmalıdır ve ritmik bir şekilde (her adım arasında eşit zaman) yapılmalıdır ve ileri veya geri hareket değil 10x tekrarlanır. </li></ol></li><li> Durarak uzun atlama: Git ileri f gibi iki ayak ile ayaktayapabilirsiniz ve 3 saniye boyunca iniş tutun gibi ar. Tedbir ve uzak arka ayağının önünden mesafe kaydetmek. Üç deney uzak mesafe elde etmek için verilmiştir </li></ol></li></ol> 4. Post-yaralanma / Takip Testi <ol><li> Konu sarsıntı sonrası belirtilerin yaşandığı iken sarsıntı sonrası verilerin elde edilmesi <ol><li> Bir konu bir yaralanma uğrar Aynı gün, araştırma personeli telefon veya e-posta kullanarak konuya temas ettirilir. Araştırma personel yaralanmayla ilgili klinik ve fonksiyonel ayrıntıları kaydeder. </li><li> Hemen (24-48 saat sonrası yaralanma) sarsıntı sonrasında, toplamak: devlet KHD verileri (tekrar, 1,5-1,10 1.3 adımlar) dinlenme; sarsıntı sonrası semptom veri (tekrar adım 1.4); ve denge verileri (adımı tekrarlayın 3.1). Belirtiler test sırasında şiddetlenir ise, veri toplama durdurmak ve geri kalanı tabi izin verir. </li><li> Devlet KHD verileri (tekrar, 1,5-1,10 1.3 adım), sarsıntı sonrası semptom verilerini (tekrar adım 1.4) istirahat toplamaya devam, veHaftalık sarsıntı sonrası belirtilerin kadar dengesi verileri (tekrar adım 3.1) giderilmiştir. Belirtiler test sırasında şiddetlenir ise, veri toplama durdurmak ve geri kalanı tabi izin verir. </li><li> Araştırma personel sarsıntı sonrası semptomlar (PCSI-C kullanarak) çözmek belirlemek için telefonla tabi haftalık ile takip. </li></ol></li></ol> Konu Kalmayan post-sarsıntı Belirtileri Deneyimi iken 5. Post-sarsıntı Veri Edinme <ol><li> Sarsıntı sonrası semptomlar düzeldi 1 hafta sonra, toplamak: devlet KHD verileri (tekrar, 1,5-1,10 1.3 adımlar) dinlenme; sarsıntı sonrası semptom veri (tekrar adım 1.4); bilişsel performans verileri (tekrar 2,1-2,2 adımlar); dengesi verileri (adımı tekrar 3.1); grip verileri (adımı tekrar 3.2); ve, çeviklik / motor becerileri veri (adım 3.3). Belirtiler test sırasında şiddetlenir ise, veri toplama durdurmak ve geri kalanı tabi izin verir. </li><li> Çözmüş sarsıntı sonrası belirtiler 1 ay sonra, adım 5.1 tekrarlayın. Yazılan 3 ay sonra-concussion belirtiler, adımı tekrarlayın 5.1 giderilmiştir. Sonrası beyin sarsıntısı belirtileri çözmüş 6 ay sonra, adımı tekrarlayın 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.

Bu protokol bir sarsıntı takip gençlik sporcular kurtarma ölçme bir multi-modal yaklaşım sunuyor. Bu protokolün bir kritik özelliği / dayanak yaralanma öncesi (devlet kalp hızı değişkenliği, vb dinlenme biliş, denge, güç, çeviklik,) performans etki geniş bir yelpazesinde sarsıntı sonrası verilerin karşılaştırılması olduğunu. Bu veriler, beyin sarsıntısı, aşağıdaki ayrı ayrı Genç sporcu arasında iyileşme göstermek için bir araç olarak hizmet eder. Biliş, denge, güç...

Beyin sarsıntısı 1 &quot;travmatik biyomekanik güçler tarafından uyarılan beyin etkileyen bir karmaşık patofizyolojik süreç&quot; olarak tanımlanabilir ve kısa ve uzun vadeli somatik, bilişsel ve / veya duygusal / davranışsal belirtiler 2 neden olabilir. İşlevsel olarak, sarsıntı ve ilgili semptomların günlük aktivitelerde kişinin katılımı üzerinde önemli bir etkiye sahip ve 3 peşindedir edebilirsiniz. Bu Amerika Birleşik Devletleri içinde, 1.6 ve 3.8 milyon sarsıntının arasındaki spor katılımı 4 bir sonucu olarak her yıl meydana geldiği tahmin edilmektedir. Spor yapan çocuk ve gençlere özgü, sarsıntı en sık bildirilen yaralanmaların 5-7 biridir. Günlük faaliyetleri ve çocukların ve gençlerin arasında sarsıntının yaygınlığı ile ilgili olabilir etkisi sarsıntı rağmen, gençlik beyin performansı etki çeşitli genelinde sarsıntının nasıl tepki raporlama bilimsel verilerin yetersiz bulunmaktadır. Baseline tdair ilginç, ya da kurtarma bilgilendirmek için post-yaralanma test puanları karşılaştırmak için bir kriter olarak hasar öncesi test puanları kullanımı, gençlik spor toplum içinde artan popülaritesi bir uygulamadır ve kullanışlı eklemek için &quot;yardımcı olmak için uluslararası 8 ileri sürülmüştür sarsıntının yönetimi sırasında bilgi &quot;(s.3). En iyi (bilişsel ve duygusal / davranışsal somatik) sarsıntı sonrası belirtilerin çeşitli doğasını temsil etmek amacıyla, sarsıntı sonrası iyileşme değerlendirme sonucu çeşitli önlemler içermesi önemlidir. Ayrıca, mevcut sarsıntı yönetimi sarsıntı sonrası belirtilerin subjektif raporunda dayanır. Bu subjektif raporun geçerlilik faktörlerin 9 çeşitli etkilenmiş olabilir ve belirtiler 10,11 altında-raporlama ve iyileşme daha az doğru ve güvenilir indeksi hem de yol açabilir. Bunun bir sonucu olarak, ölçme PERFORMAN arasında, organik beyin kurtarma yaklaşımları keşfetmek için önemli bir ihtiyaç bulunmaktadırnesnel ve duyarlı hem de ce etki. O biliş, denge, kuvvet kanıtlanmıştır ve çeviklik sarsıntı ve beyin hasarı 12-17 aşağıdaki gençliğinde bozulabilir. Bu test protokolü içinde yer tedbirler sarsıntının ardından bu etki karşısında toparlanma içgörü sağlamak ve yaygın beyin sarsıntısı yönetimine odaklı klinik ortamlarda kullanılan valide klinik test araçlarının kullanımı dahil etmek seçildi. Dahası, bir daha keşif bakış açısıyla, dinlenme devlet KHD sempatovagal denge 18,19 kesin bir ölçü olarak görülebilir. Sempatik sistem tonik inhibitör kontrolü altında iken sağlıklı popülasyonda, sempatovagal denge, istirahat baskın olma parasempatik sistem olarak tanımlanır. Nedeniyle fizyolojik stres, post-beyin sarsıntısı hipotezi, iki sistem arasında bir dengesizlik var ve devlet dinlenme hiperaktivite kayabilirsempatik sistem ve parasempatik sistem 20 hipoaktivite. Bu çalışmanın protokolün amacı sarsıntının Aşağıdaki iyileşme daha bütüncül objektif ve doğru bir anlayış kazanmak için gençlik sporcular (yaşları 10-18 yaş) arasında öncesi ve sonrası sarsıntı performansı çok-modlu bir değerlendirmesini yapmaktır. Bu çalışma gelişim ve çocuk ve gençlere özel sarsıntı yönetimi ve rehabilitasyon protokolleri teslim içgörü sağlamayı amaçlamaktadır.

<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>
		</tr>
		<tr>
			<td>Scale</td>
			<td>Weight Watchers: Conair&#160;</td>
			<td>WW30WB</td>
			<td></td>
		</tr>
		<tr>
			<td>Measuring Tape</td>
			<td>Hi-Viz Lufkin</td>
			<td>HVC716CME</td>
			<td></td>
		</tr>
		<tr>
			<td>Heart Rate Monitor (Chest Strap and Watch)</td>
			<td>Polar</td>
			<td>RS800CX GPS</td>
			<td></td>
		</tr>
		<tr>
			<td>Exercise/Yoga Mat</td>
			<td>Pur Athletics</td>
			<td>WTE10126</td>
			<td></td>
		</tr>
		<tr>
			<td>Sportline Stopwatch (Model 228)</td>
			<td>EB Sport Group</td>
			<td>#2787</td>
			<td></td>
		</tr>
		<tr>
			<td>Laptop - MacBook Pro</td>
			<td>Apple</td>
			<td>A1278</td>
			<td></td>
		</tr>
		<tr>
			<td>Computerized Cognitive Assessment- Immediate Post-Concussion Assessment and Cognitive Task</td>
			<td>ImPACT Application&#39;s Inc.&#160;</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Hand Grip Dynamometer</td>
			<td>Sammons Preston- Smedley-Type</td>
			<td>5032P</td>
			<td></td>
		</tr>
		<tr>
			<td>BioSway</td>
			<td>Biodex Medical Supplies Inc.&#160;</td>
			<td>950-510</td>
			<td></td>
		</tr>
		<tr>
			<td>Painter&#39;s Mate Green Tape</td>
			<td>ShurTech Brands LLC</td>
			<td>#49462</td>
			<td></td>
		</tr>
		<tr>
			<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>
		</tr>
		<tr>
			<td>Bean Bags</td>
			<td>Eastpoint/Go Gater</td>
			<td>1-1-16392</td>
			<td></td>
		</tr>
	</tbody>
</table>

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

Beyin sarsıntısı spor katılımı katılan çocuk ve gençler arasında en sık bildirilen yaralanmalardan biridir. Bir sarsıntının ardından, gençlik, günlük aktiviteler ve ilgi takipçiliği (örneğin, okul, spor, iş kişinin katılımı üzerinde önemli bir etkisi olabilir, kısa ve uzun vadeli davranış semptomları bir dizi (bilişsel ve duygusal somatik, davranışsal /) yaşayabilirsiniz Aile / sosyal hayatı, vb.) Buna rağmen, bir gençlik spor nüfus içinde beyin sarsıntısı keşfetmek standartlarını hedefleyen klinik güdümlü araştırmaların azlığı ve kurtarma ölçme daha spesifik, multi-modal yaklaşımlar kalır. Bu makalede, sarsıntının aşağıdaki gençlik sporcular arasında iyileşmeyi ölçmede bir roman ve multi-modal yaklaşımın genel bir bakış sağlar. Sunulan yaklaşım etki geniş bir yelpazede genelinde performansını değerlendirmek için önceden-yaralanma / temel test ve post-yaralanma hem de / takip test kullanımını gerektirir (post-concussion belirtiler, biliş, denge, güç, çeviklik / motor becerileri ve dinlenme devlet kalp hızı değişkenliği). Bu araştırmanın amacı, gençlik sporcular (yaşları 10-18 yaş) sarsıntının takip toparlanma daha objektif ve doğru bir anlayış kazandırmaktır. Bu araştırma bulguları gençlik spor topluma yönetimi ve rehabilitasyon spesifik beyin sarsıntısı geliştirme ve gelişmiş yaklaşımların kullanımı konusunda bilgilendirmek için yardımcı olabilir.

Sunulan protokol devam eden bir soruşturma. Tablo 1 protokolün test yönetimi programı göstermektedir. Temsilcisi sonuçları gençliğinde sarsıntının etkileneceği bilinen performans etki çeşitli genelinde temel / yaralanma öncesi ve sonrası sarsıntı veri toplama uygulanabilirliğini göstermek için sunulmaktadır. Seçilmiş sonuç önlemler karşısında kurtarma yörüngeleri göstermek için sunulan protokolünün tüm aşamalarını tamamlamış bir beyin sarsıntısı gençlik tek ...

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.

Concussion ardından Gençlik Sporcular değerlendirilmesi Kurtarma A Multi-Modal Yaklaşım

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

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

Research

JoVE Journal

Medicine

13.3K Görüntüleme.  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.

Video: 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.

Fonksiyonel Manyetik Rezonans Görüntüleme ve Head Impact Telemetri Sistemi kullanarak Gençlik Sporla ilgili Beyin sarsıntısı Etkileri Üzerine Bir Araştırma

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 ...

Tıp

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.

Fetal Alkol Pozlama bir Zebra balığı Modelinde teratojenik değişiklikler değerlendirilmesi

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.

Manyetik Rezonans Görüntüleme, Volumetrik Bilgisayarlı Tomografi ve Ultrason Kullanımı Meme Kanseri Kemik metastazı bir Nude Rat Model Angiogenezis Multi-modal Görüntüleme

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.

Öğrenci-sporcularda sarsılmaların Sınavı Bir nörobilimsel Yaklaşım

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.

Kapsamlı Bir Atlama Protokolünü takiben Öznel ve Nesnel Kurtarma Özelliklerinin İnvaziv Olmayan Değerlendirmeleri

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.

Parenteral Beslenme için Zeytinyağı Bazlı Üç Odalı Poşetlerin Güvenliğini, Etkinliğini ve Teslimini Değerlendiren Klinik Bir Çalışma

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.

Beyin sarsıntısı gençlik sporcular aşağıdaki otonomik fonksiyon: kalp hızı değişkenliği 24 saatlik kayıt metodoloji kullanarak bir keşif

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.

İnsan jinjiva greft neovaskülarizasyon izleme için yeni bir yaklaşım

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.

Büyük erişkinlerde izleme multi-modal ev uyku

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.

Gençler ve yetişkinler ile beyin sarsıntısı için bakım Pathway gelişmiş geliştirme ve multi-disipliner bir teknolojisi

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