The Predictive Capacity of the Buffalo Concussion Treadmill Test After Sport-Related Concussion in Adolescents
Autor: | Mohammad N. Haider; John J. Leddy; Charles G. Wilber; Kaitlin B. Viera; Itai Bezherano; Kimberly J. Wilkins; Jeffrey C. Miecznikowski; Barry S. Willer |
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Sprache: | Englisch |
Veröffentlicht: |
2019 |
Quelle: | Directory of Open Access Journals: DOAJ Articles |
Online Zugang: |
https://www.frontiersin.org/article/10.3389/fneur.2019.00395/full https://doaj.org/toc/1664-2295 1664-2295 doi:10.3389/fneur.2019.00395 https://doaj.org/article/ba75ac3f44bf4ee3b748f7ca91533adb https://doi.org/10.3389/fneur.2019.00395 https://doaj.org/article/ba75ac3f44bf4ee3b748f7ca91533adb |
Erfassungsnummer: | ftdoajarticles:oai:doaj.org/article:ba75ac3f44bf4ee3b748f7ca91533adb |
Zusammenfassung
The Buffalo Concussion Treadmill Test (BCTT) identifies the heart rate threshold (HRt) of exercise tolerance in concussed patients. A previous study found that an absolute HRt of < 135 bpm was associated with prolonged recovery (>30 days) from sport-related concussion (SRC). In this study, we assessed the relationship of ΔHR (difference between resting HR and HRt) and recovery from SRC. Using a retrospective cohort design, we compared acutely (<10 days since injury) concussed adolescents who were prescribed either (1) relative rest (RG, n = 27, 15.2 ± 1 years, 33% female, median 17 days to recovery, ΔHR = 69.6 ± 28 bpm), (2) a placebo-stretching program (PG, n = 51, 15.4 ± 2 years, 49% female, median 17 days to recovery, ΔHR = 60.9 ± 22 bpm), or (3) sub-threshold aerobic exercise (AG, n = 52, 15.3 ± 2 years, 46% female, median 13 days to recovery, ΔHR = 62.4 ± 26 bpm). Linear regression showed that ΔHR significantly correlated with duration of clinical recovery for RG (p = 0.012, R2 = 0.228) and PG (p = 0.011, R2 = 0.126) but not for AG (p = 0.084, R2 = 0.059). ΔHR values were significantly lower in participants with prolonged recovery (>30 days) in RG (p = 0.01) and PG (p = 0.04). A ΔHR of ≤50 bpm on the BCTT is 73% sensitive and 78% specific for predicting prolonged recovery in concussed adolescents who were prescribed the current standard of care (i.e., cognitive and physical rest).