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Safety and Prognostic Utility of Provocative Exercise Testing in Acutely Concussed Adolescents: A Randomized Trial.

Abstract To evaluate (1) systematic assessment of exercise tolerance in adolescents shortly after sport-related concussion (SRC) and (2) the prognostic utility of such assessment.
PMID
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Authors

Mayor MeshTerms

Exercise Tolerance

Keywords
Journal Title clinical journal of sport medicine : official journal of the canadian academy of sport medicine
Publication Year Start




PMID- 29257777
OWN - NLM
STAT- MEDLINE
DCOM- 20180109
LR  - 20180109
IS  - 1536-3724 (Electronic)
IS  - 1050-642X (Linking)
VI  - 28
IP  - 1
DP  - 2018 Jan
TI  - Safety and Prognostic Utility of Provocative Exercise Testing in Acutely
      Concussed Adolescents: A Randomized Trial.
PG  - 13-20
LID - 10.1097/JSM.0000000000000431 [doi]
AB  - OBJECTIVE: To evaluate (1) systematic assessment of exercise tolerance in
      adolescents shortly after sport-related concussion (SRC) and (2) the prognostic
      utility of such assessment. DESIGN: Prospective randomized controlled trial.
      SETTING: University and community sports medicine centers. PARTICIPANTS:
      Adolescents with SRC (1-9 days from injury). Sixty-five were randomized and 54
      completed the study (mean age 15 years, 4 days after injury). INTERVENTIONS:
      Buffalo Concussion Treadmill Test (BCTT, n = 27) or not (controls, n = 27) on
      visit day #1. Heart rate threshold (HRt) at symptom exacerbation represented
      level of exercise tolerance. Participants reported symptoms daily for 14 days and
      then had follow-up BCTT (n = 54). Recovery was defined as returning to normal
      level of symptoms and exercise tolerance, verified by independent physician
      examination. MAIN OUTCOME MEASURES: Days to recovery and typical (</=21 days)
      versus prolonged recovery (>21 days). Mixed effects linear models and linear
      regression techniques examined symptom reports and time to recovery. Linear
      regression assessed the association of HRt with recovery time. RESULTS: Days to
      recovery (P = 0.7060) and typical versus prolonged recovery (P = 0.1195) were not
      significantly different between groups. Symptom severity scores decreased in both
      groups over 14 days (P < 0.0001), were similar (P = 0.2984), and did not
      significantly increase the day after the BCTT (P = 0.1960). Lower HRt on visit
      day #1 was strongly associated with prolonged recovery time (P = 0.0032).
      CONCLUSIONS: Systematic evaluation of exercise tolerance using the BCTT within 1 
      week after SRC did not affect recovery. The degree of early exercise intolerance 
      after SRC was important for prognosis. This has implications for school academic 
      and team preparation.
FAU - Leddy, John J
AU  - Leddy JJ
AD  - From the *UBMD Orthopaedics and Sports Medicine, SUNY Buffalo, Buffalo, New
      York;daggerDepartment of Biostatistics, SUNY Buffalo, Buffalo, New York;double
      daggerExcelsior Orthopedics and the Department of Family Medicine, SUNY Buffalo, 
      Buffalo, New York; section signNuclear Medicine, SUNY Buffalo, Buffalo, New York;
      paragraph signDepartment of Internal Medicine, SUNY Buffalo, Buffalo, New York;
      and ||Department of Psychiatry, SUNY Buffalo Jacobs School of Medicine and
      Biomedical Sciences, Buffalo, New York.
FAU - Hinds, Andrea L
AU  - Hinds AL
FAU - Miecznikowski, Jeffrey
AU  - Miecznikowski J
FAU - Darling, Scott
AU  - Darling S
FAU - Matuszak, Jason
AU  - Matuszak J
FAU - Baker, John G
AU  - Baker JG
FAU - Picano, John
AU  - Picano J
FAU - Willer, Barry
AU  - Willer B
LA  - eng
GR  - R01 NS094444/NS/NINDS NIH HHS/United States
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - Clin J Sport Med
JT  - Clinical journal of sport medicine : official journal of the Canadian Academy of 
      Sport Medicine
JID - 9103300
SB  - IM
MH  - Adolescent
MH  - Athletic Injuries/*diagnosis
MH  - Brain Concussion/*diagnosis
MH  - Exercise Test/*methods
MH  - *Exercise Tolerance
MH  - Female
MH  - Humans
MH  - Linear Models
MH  - Male
MH  - Prognosis
MH  - Prospective Studies
PMC - PMC5739074
MID - NIHMS848984
EDAT- 2017/12/20 06:00
MHDA- 2018/01/10 06:00
CRDT- 2017/12/20 06:00
PMCR- 2019/01/01 00:00
PHST- 2019/01/01 00:00 [pmc-release]
PHST- 2017/12/20 06:00 [entrez]
PHST- 2017/12/20 06:00 [pubmed]
PHST- 2018/01/10 06:00 [medline]
AID - 10.1097/JSM.0000000000000431 [doi]
AID - 00042752-201801000-00002 [pii]
PST - ppublish
SO  - Clin J Sport Med. 2018 Jan;28(1):13-20. doi: 10.1097/JSM.0000000000000431.