Use of the Buffalo Concussion Treadmill Test in community adult patients with mild traumatic brain injury.

IF 2.2 4区医学 Q1 REHABILITATION

PM&R Pub Date : 2024-08-01 Epub Date: 2024-02-27 DOI:10.1002/pmrj.13132

Andrew DeGroot, Daniel L Huber, John J Leddy, Hershel Raff, Michael A McCrea, Blair D Johnson, Lindsay D Nelson

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引用次数: 0

Abstract

Background: The Buffalo Concussion Treadmill Test (BCTT) is used to establish exercise tolerance for rehabilitation and identify injury subtypes for youth athletes after mild traumatic brain injury (mTBI). Its utility in adult community members is unknown.

Objective: Primary: To describe how adults with and without mTBI tolerate the BCTT. Secondary: To explore relationships between baseline factors, mTBI-related symptoms, and BCTT duration.

Design: Prospective, observational, longitudinal.

Setting: Academic medical center.

Participants: Thirty-seven adults treated in a level 1 trauma center emergency department with mTBI; 24 uninjured controls (UC).

Interventions: N/A.

Main measures: Participants completed two visits 3 weeks apart (1 week and 1 month after mTBI) including a 15-minute BCTT, the Rivermead Post Concussion Symptoms Questionnaire (RPQ), and preinjury International Physical Activity Questionnaire. Analyses characterized BCTT response and associations between baseline factors, RPQ scores, and BCTT duration.

Results: Persons with mTBI discontinued earlier than UC at 1-week postinjury using standard discontinuation criteria for exercise intolerance. The percentage of mTBI participants with signs of possible mTBI-related intolerance was 55.6% at 1 week (36.1% for mTBI-related symptom exacerbation, 19.4% for exertion/fatigue before reaching 85% of one's age-predicted maximum heart rate [HR]) and 48.0% at 1 month (40.0% mTBI-related symptom exacerbation, 8.0% exertion without reaching the target HR). Thirty percent of UCs completed the BCTT at both assessments. UCs met discontinuation criteria for increased nonspecific symptoms (eg, pain/general discomfort and increased Visual Analog Scale ratings; 39-61%) and physical exertion (9-26%). Shorter duration was associated with higher body mass index (r = -0.42 - -0.45), shorter height (r = 0.22-0.29), female gender (r = -0.26 - -0.27), and greater RPQ symptoms (r = -0.28 - -0.47).

Conclusion: The BCTT exacerbates mTBI-related symptoms in adult community members. Participant characteristics and noninjury factors influence performance. The findings imply the BCTT could be useful in clinical assessments of adults with mTBI. Interpretation should account for the unique characteristics of nonathletes.

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在社区轻度脑外伤成年患者中使用布法罗脑震荡跑步机测试。

背景：布法罗脑震荡跑步机测试（BCTT）用于确定运动耐受性，以帮助青少年运动员在轻微创伤性脑损伤（mTBI）后进行康复训练并确定损伤亚型。该测试对成年社区成员的实用性尚不清楚：主要目的：描述患有和未患有轻度脑损伤的成年人对 BCTT 的耐受情况。次要目标：探讨基线因素、mTBI 相关症状和 BCTT 持续时间之间的关系：设计：前瞻性、观察性、纵向：学术医疗中心：37名在一级创伤中心急诊科接受治疗的mTBI成人；24名未受伤对照组（UC）：不适用：参与者完成两次访问，每次间隔 3 周（mTBI 后 1 周和 1 个月），包括 15 分钟 BCTT、Rivermead 脑震荡后症状问卷 (RPQ) 和受伤前国际体育活动问卷。分析了 BCTT 反应的特点以及基线因素、RPQ 分数和 BCTT 持续时间之间的关联：结果：根据运动不耐受的标准中止标准，mTBI 患者在伤后 1 周的中止时间早于 UC 患者。1周时，有可能出现与mTBI相关的不耐受迹象的mTBI参与者比例为55.6%（36.1%为与mTBI相关的症状加重，19.4%为在达到年龄预测的最大心率[HR]的85%之前出现劳累/疲劳），1个月时为48.0%（40.0%为与mTBI相关的症状加重，8.0%为未达到目标心率的劳累）。30%的 UC 在两次评估中均完成了 BCTT。非特异性症状加重（如疼痛/全身不适和视觉模拟量表评分增加；39-61%）和体力消耗（9-26%）的 UC 符合终止标准。持续时间较短与体重指数较高（r = -0.42 -0.45）、身高较矮（r = 0.22-0.29）、女性（r = -0.26 -0.27）和 RPQ 症状较多（r = -0.28 -0.47）有关：结论：BCTT会加重成年社区成员的mTBI相关症状。参与者的特征和非损伤因素会影响其表现。研究结果表明，BCTT可用于mTBI成人的临床评估。解释时应考虑到非运动员的独特特征。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

PM&R REHABILITATION-SPORT SCIENCES

CiteScore

4.30

自引率

4.80%

发文量

187

审稿时长

4-8 weeks

期刊介绍： Topics covered include acute and chronic musculoskeletal disorders and pain, neurologic conditions involving the central and peripheral nervous systems, rehabilitation of impairments associated with disabilities in adults and children, and neurophysiology and electrodiagnosis. PM&R emphasizes principles of injury, function, and rehabilitation, and is designed to be relevant to practitioners and researchers in a variety of medical and surgical specialties and rehabilitation disciplines including allied health.