前庭症状对运动相关脑震荡后重返赛场的前庭眼动筛查的预后价值：系统综述与荟萃分析
Prognostic Value of Vestibular Symptoms on the Vestibular Ocular Motor Screening for Return-to-play After Sport-related Concussion: A Systematic Review and Meta-analysis.
文献信息
| PMID | 42876117 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Romina Rahmaniharedasht |
| 作者单位 | Translational Rehabilitation Sciences Group, Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy (R.R., M.A., S.Z., A.T., P.P., M.T., N.T.); Laboratory of Neuromotor Physiology, LIFE Institute for Research and Health Care Santa Lucia IRCCS, Rome, Italy (D.P.); Professional Development and Implementation of Research in Health Professions Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy (A.T.); and Unit of Occupational Medicine, IRCCS University Hospital of Bologna, Bologna, Italy (P.P., M.T.). |
| 期刊 | Journal of neurologic physical therapy : JNPT |
| SCI 分区 | Q1 |
| IF | 4.6 |
| 研究类型 | 综述 Meta · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景与目的： 前庭眼反射（VOR）有助于头部运动后的凝视稳定，但其对运动相关脑震荡（SRC）后重返赛场（RTP）的独立预后价值尚不明确。本系统综述与荟萃分析探讨了早期前庭眼动筛查（VOMS）评估与SRC后RTP持续时间之间的关联。
方法： 检索PubMed、CINAHL、Scopus、PEDro和Cochrane Library至2025年3月，纳入在SRC后14天内进行评估并报告RTP结局的研究。两名评价者提取数据并评估偏倚风险。对报告恢复延迟（≥28-30天）的研究进行随机效应荟萃分析。
结果： 12项研究（N = 3297名运动员）符合纳入标准。对4项研究（n = 968）的荟萃分析发现，VOMS筛查阳性与恢复延迟的几率增加相关（比值比2.39；95%置信区间1.82-3.13；P < 0.00001；I2=0%）。在9项孤立VOR增益研究中，8项报告与更长的RTP存在显著单变量关联，但仅2项在多变量调整后仍保持显著。VOMS能可靠识别有迁延恢复风险的运动员，但孤立的VOR指标在调整后显示出不一致的独立预测价值。
讨论与结论： 需要客观的VOR增益量化（如vHIT、冷热试验）来阐明生理性VOR功能障碍是否独立影响恢复。临床医生应在多模式评估中解读VOR发现。
英文摘要
BACKGROUND AND PURPOSE: The vestibulo-ocular reflex (VOR) contributes to gaze stabilization after head movement, but its independent prognostic value for return-to-play (RTP) after sport-related concussion (SRC) is unclear. This systematic review and meta-analysis examined associations between early vestibular-ocular motor screening (VOMS) assessment and RTP duration following SRC.
METHODS: Searches of PubMed, CINAHL, Scopus, PEDro, and Cochrane Library to March 2025 identified studies assessing within 14 days of SRC and reporting RTP outcomes. Two reviewers extracted data and assessed the risk of bias. Random-effects meta-analysis was performed for studies reporting prolonged recovery (≥28-30 days).
RESULTS: Twelve studies (N = 3297 athletes) met inclusion criteria. Meta-analysis of four studies (n = 968) found a positive VOMS screen was associated with increased odds of prolonged recovery (odds ratio 2.39; 95% confidence interval, 1.82-3.13; P < 0.00001; I2=0%). Among nine studies of isolated VOR gain, eight reported significant univariate associations with longer RTP, but only two retained significance after multivariable adjustment. VOMS reliably identifies athletes at risk for protracted recovery, but isolated VOR measures show inconsistent independent predictive value after adjustment.
DISCUSSION AND CONCLUSIONS: Objective VOR gain quantification (eg, vHIT, caloric) is needed to clarify whether physiological VOR dysfunction independently affects recovery. Clinicians should interpret VOR findings within a multimodal assessment.