TY - JOUR
T1 - Measurement of improvement on repeat exercise intolerance testing for suspected dysautonomia in protracted concussion recovery
T2 - a retrospective cohort study
AU - Ziaks, Lauren
AU - Tucker, Jenna
AU - Koc, Thomas
AU - Hanson, Kristina
AU - Puxted, Freya
N1 - Publisher Copyright:
© 2022 Taylor & Francis Group, LLC.
PY - 2024
Y1 - 2024
N2 - Background: Research has demonstrated concussion likely causes autonomic dysfunction leading to exercise intolerance. Objective: To measure improvement in exercise intolerance due to suspected dysautonomia associated with protracted concussion recovery, using objective measurements on a Buffalo Concussion Treadmill Test (BCTT) following participation in a prescribed exercise program. Methods: This is a retrospective cohort study of 101 patient charts post-concussion. Exercise intolerance was assessed using a BCTT to identify suspected dysautonomia and an exercise prescription was provided using guidelines for treating concussion-associated exercise intolerance. Patients without symptom improvement and/or inability to achieve 80–85% of age-expected maximum heart rate (HR) without symptom exacerbation received a repeat BCTT. Results: Twelve patient charts met inclusion criteria and were included in data analysis. There were significant improvements from pre-intervention to post-intervention testing in: maximum BCTT stage mean scores (p = .02); maximum HR mean scores (p = .01); prescription HR (RxHR) mean scores (p = .01); and HR delta (HR (Formula presented.)) mean scores (p = .00). Conclusions: Maximum stage, HR threshold, RxHR, and newly identified HR delta (HR (Formula presented.)) are potential objective measurements of progress for dysautonomia treatment post-concussion. Future studies are indicated to create a tailored protocol in the management of protracted concussion-associated dysautonomia.
AB - Background: Research has demonstrated concussion likely causes autonomic dysfunction leading to exercise intolerance. Objective: To measure improvement in exercise intolerance due to suspected dysautonomia associated with protracted concussion recovery, using objective measurements on a Buffalo Concussion Treadmill Test (BCTT) following participation in a prescribed exercise program. Methods: This is a retrospective cohort study of 101 patient charts post-concussion. Exercise intolerance was assessed using a BCTT to identify suspected dysautonomia and an exercise prescription was provided using guidelines for treating concussion-associated exercise intolerance. Patients without symptom improvement and/or inability to achieve 80–85% of age-expected maximum heart rate (HR) without symptom exacerbation received a repeat BCTT. Results: Twelve patient charts met inclusion criteria and were included in data analysis. There were significant improvements from pre-intervention to post-intervention testing in: maximum BCTT stage mean scores (p = .02); maximum HR mean scores (p = .01); prescription HR (RxHR) mean scores (p = .01); and HR delta (HR (Formula presented.)) mean scores (p = .00). Conclusions: Maximum stage, HR threshold, RxHR, and newly identified HR delta (HR (Formula presented.)) are potential objective measurements of progress for dysautonomia treatment post-concussion. Future studies are indicated to create a tailored protocol in the management of protracted concussion-associated dysautonomia.
KW - Buffalo Concussion Treadmill Test
KW - exercise prescription
KW - reevaluation
UR - http://www.scopus.com/inward/record.url?scp=85138250161&partnerID=8YFLogxK
U2 - 10.1080/09593985.2022.2121949
DO - 10.1080/09593985.2022.2121949
M3 - Article
C2 - 36074009
AN - SCOPUS:85138250161
SN - 0959-3985
VL - 40
SP - 468
EP - 476
JO - Physiotherapy Theory and Practice
JF - Physiotherapy Theory and Practice
IS - 3
ER -