较高海拔并不能减少脑震荡风险


  【24drs.com】一篇新的统合分析结果认为,较高海拔处与在海平面高度处相比,与接触性运动相关的脑震荡发生率之间并无关联。研究者表示,这些研究结果应可平息「在高海拔地区较少运动相关之脑震荡」的想法。
  
  北卡罗来纳海波特大学物理治疗系James M. Smoliga博士、亚特兰大格鲁吉亚州立大学呼吸治疗系Gerald S. Zavorsky博士等作者们结论指出,有关此议题的进一步研究,将会使资源从更有临床效果的研究偏离,研究目标应是确认可修改的脑震荡风险因素、发展可改善运动员安全的完善科学技术、改善运动相关脑部伤害的急性与长期处置。
  
  这些研究结果在线发表于9月6日JAMA神经学期刊中的研究信函。
  
  系统性回顾美国国家医学图书馆中的已发表文献之后,作者们选了三篇研究进行统合分析:
  * Lynall等人。本研究使用2009-2014年全国大学生田径协会伤害监测计划之资料,探讨甲组足球选手的脑震荡伤害;
  * Myer 等人。研究者探讨了2012-2013年间国家美式足球联盟选手的脑震荡发生率,资料来自各球队的官方网站以及PBS Frontline Concussion Watch网站资源;
  * Smith等人。分析了在2005-2015年间9所高中参与运动之青少年的脑震荡发生率,资料来自全国高中体育相关伤害监测系统。
  
  这篇纳入近500万笔资料的统合分析发现,每个运动员(每次比赛)曝露的不良事件次数,在海平面高度处的范围是大约介于 0.07% -0.45%,在高海拔处的比率相当,范围介于0.06%- 0.50%。
  
  相较于较高海拔处,海平面高度处的脑震荡相对风险并无差异,作者们发现,没有证据发表偏见。
  
  作者们写道,结果显示海拔与脑震荡风险之间没有临床关联;从公卫角度来看,即便海拔可以保护运动员免于脑震荡,海拔并非可轻易改变的因素,其价值有限。
  
  作者们强调,宣称可复制海拔影响的运动防护设备都没有科学依据,因此,我们坚信,流行病学数据已经足以表明,此议题无需进一步研究。
  
  资料来源:http://www.24drs.com/
  
  Native link:Higher Altitude Doesn't Reduce Concussion Risk

Higher Altitude Doesn't Reduce Concussion Risk

By Pauline Anderson
Medscape Medical News

There is no association between the incidence of contact sports–related concussion at higher attitudes and that seen at sea level, results of a new meta-analysis suggest.

The findings should put to rest the idea that there are fewer sports-related concussions at higher altitudes, the researchers say.

"Further research on this issue will simply divert resources from more clinically effective research aimed at identifying modifiable risk factors for concussion, developing scientifically sound technologies that improve athlete safety, and improving acute and long-term management of sports-related head injuries," the authors, Gerald S. Zavorsky, PhD, Department of Respiratory Therapy, Georgia State University, Atlanta, and James M. Smoliga, PhD, Department of Physical Therapy, High Point University, North Carolina, conclude.

The results were published online September 6 as a research letter in JAMA Neurology.

After a systematic review of the published literature using the US National Library of Medicine database, the authors selected three studies for the meta-analysis:

  • Lynall et al. This study looked at Division 1 football concussion injuries using data from the National Collegiate Athletics Association Injury Surveillance Program from 2009 to 2014;

  • Myer et al. Researchers looked at concussion rates among National Football League players in 2012 and 2013, with data from each team's official website and from the PBS Frontline Concussion Watch web-based resource; and

  • Smith et al. This analysis of concussion rates in adolescents participating in nine high school sports between 2005 and 2012 used data from the National High School Sports Related Injury Surveillance System.

The meta-analysis, which included nearly 5 million data points, showed that the number of adverse events per athlete exposure (one game) at sea level ranged from about 0.07% to 0.45%, which was similar to the rate at higher altitudes, where they ranged from 0.06% to 0.50%.

There was no difference in the relative risk for concussion at sea level compared with at higher altitude. The authors found no evident publication bias.

The results demonstrate "that there is no clinically relevant association between altitude and concussion risk," the authors write. "Even if altitude protected athletes from concussion, altitude is not a factor that can be readily altered and is of little value from a public health standpoint."

Sports protective equipment meant to replicate the effects of altitude are not scientifically justified, the authors stressed. "As such, we firmly believe epidemiologic data are already sufficient to indicate that this is an issue that should not be examined further."

The authors have disclosed no relevant financial relationships.

JAMA Neurol. Published online September 6, 2016.

    
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