Multimodal Assessment Battery and Heart Rate Variability Enhance Clinical Utility of Buffalo Concussion Treadmill Test.

IF 1.3 4区 医学 Q3 REHABILITATION
Daniel Miner, Michael Shiraishi, Pamela Gibbons, Rahul Soangra, Brent Harper
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引用次数: 0

Abstract

Context: The Buffalo Concussion Treadmill Test (BCTT) for exercise intolerance following concussion may highlight underlying autonomic dysfunction. Autonomic function at rest and with exertion may be predictive of neurocognitive performance for individuals with sports-related concussion. The purpose of this study is to explore the feasibility and utility of combining multimodal assessments with heart rate variability (HRV) measures during the BCTT for individuals with a remote history of concussion.

Design: Prospective cohort study design, pretest/posttest.

Methods: Participants included 5 males and 5 females (N = 10, age: 25.2 [3.3] y old, height: 173.2 [11.2] cm, mass: 73.4 [13.7] kg, body mass index: 24.5 [3.9], time since last concussion of 6.3 [4.5] y). All participants completed the multimodal assessment battery including: Concentration Reverse Digits (6 digits), Stroop Incongruent, and King-Devick Test under single- (seated) and dual-task conditions (walking on treadmill at 2.0 mph, 0% incline). Heart rate and HRV was collected at rest, during the BCTT, and during postexercise recovery. HRV data were processed and analyzed based on established protocols. Paired t tests were performed for pre- and postmeasurements separately for single- and dual-task tests of the multimodal assessment battery and HRV indices.

Results: During the BCTT, HRV indices reflective of peripheral nervous system activity demonstrated a significant reduction with concomitant increase in HRV indices of sympathetic nervous system activity (P < .05). Recovery in these HRV indices toward baseline was observed during postexercise recovery. Neurocognitive performance on the Stroop task significantly improved with exercise (P < .05).

Conclusion: Implementation of multimodal assessments to evaluate physiological and neurocognitive responses to exercise in individuals with history of sports-related concussion is feasible. Addition of these objective measures may decrease reliance on self-reporting of exercise-induced symptom exacerbation, enabling clinicians to identify individuals whose neurocognitive performance or physiologic response to exercise on the BCTT deviates from the expected.

多模式评估电池和心率变异性增强水牛脑震荡跑步机试验的临床应用。
背景:水牛脑震荡跑步机测试(BCTT)脑震荡后运动不耐受可能突出潜在的自主神经功能障碍。运动相关脑震荡患者休息和运动时的自主神经功能可以预测其神经认知表现。本研究的目的是探讨多模式评估与心率变异性(HRV)测量相结合的可行性和实用性,在BCTT期间对有脑震荡病史的个体进行评估。设计:前瞻性队列研究设计,前测/后测。方法:参与者包括5男5女(N = 10),年龄:25.2[3.3]岁,身高:173.2 [11.2]cm,体重:73.4 [13.7]kg,身体质量指数:24.5[3.9],上次脑震荡时间6.3 [4.5]y。所有参与者在单(坐)和双任务条件下(在跑步机上以2.0 mph, 0%坡度行走)完成了多模式评估,包括:浓度反向数字(6位数),Stroop不一致和King-Devick测试。静息、BCTT和运动后恢复时采集心率和HRV。HRV数据根据既定方案进行处理和分析。对多模态评估组和HRV指数的单任务和双任务测试分别对测量前后进行配对t检验。结果:在BCTT期间,反映周围神经系统活动的HRV指数显著降低,同时交感神经系统活动的HRV指数升高(P)。结论:实施多模式评估来评估运动相关脑震荡史个体对运动的生理和神经认知反应是可行的。这些客观测量的增加可能会减少对运动引起的症状恶化的自我报告的依赖,使临床医生能够识别那些在BCTT上对运动的神经认知表现或生理反应偏离预期的个体。
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来源期刊
Journal of Sport Rehabilitation
Journal of Sport Rehabilitation 医学-康复医学
CiteScore
3.20
自引率
5.90%
发文量
143
审稿时长
>12 weeks
期刊介绍: The Journal of Sport Rehabilitation (JSR) is your source for the latest peer-reviewed research in the field of sport rehabilitation. All members of the sports-medicine team will benefit from the wealth of important information in each issue. JSR is completely devoted to the rehabilitation of sport and exercise injuries, regardless of the age, gender, sport ability, level of fitness, or health status of the participant. JSR publishes peer-reviewed original research, systematic reviews/meta-analyses, critically appraised topics (CATs), case studies/series, and technical reports that directly affect the management and rehabilitation of injuries incurred during sport-related activities, irrespective of the individual’s age, gender, sport ability, level of fitness, or health status. The journal is intended to provide an international, multidisciplinary forum to serve the needs of all members of the sports medicine team, including athletic trainers/therapists, sport physical therapists/physiotherapists, sports medicine physicians, and other health care and medical professionals.
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