Andrew Wilburn, Raegan Tremblay, David Brennan and Thomas Kern

University of Oklahoma, OU-TU School of Community Medicine, Tulsa, OK

According to the 2017 Youth Risk Behavior Survey, 15.1% of students within the US reported a sports-related concussion (SRC) within the last year1. After a SRC, the brain undergoes significant physiological changes, including a 50% reduction in glucose metabolism and cerebral blood flow2. These cerebral metabolic changes can persist for 7 to 10 days, confounding the time for return to physical activity2-5. PURPOSE: Recent research suggests sub-symptom threshold exercise in the early stages of a SRC may enhance recovery 6-9. This study investigates the relationship between treadmill performance (VO2peak) and Post-Concussion Symptom Score (PCSS) after exercise following a SRC. METHODS: A retrospective analysis of concussed athletes’ VO2Peak, pre-post exercise symptomatology (PCSS), balance (mBESS), and reaction time (RT). Medical records of 53 student athletes (Mean age, 14.2 years, 31 females), diagnosed with a SRC on presentation at The University of Oklahoma Center for Concussion (Jan. 1, 2017-Dec. 31, 2019), were reviewed. Athletes were categorized into one of two groups: 1) VO2Peak < VO2pred (n = 22) and 2) VO2Peak ≥ VO2pred (n = 31). Independent T-Test assessed group differences (α <.05, 2-tailed) for pre and post exercise PCSS, mBESS, and RT. RESULTS: For the VO2Peak < VO2pred group, 22% reported an increase in post exercise PCSS, 27% saw no change and 45% reported a reduction. For the VO2Peak ≥VO2pred group only 16.5% reported an increase in post exercise PCSS, 45% had no change, and 32% reported a reduction. There were no statistically significant mean group differences (MD) for Age MD = -.776, SE ±.738, t(51) = -1.051, p = .298, g = 0.289, Pre-exercise PCSS MD = -8.0 SE ±4.2, t(29.1) = -1.89, p = .068, g = 0.583, Post-exercise PCSS, MD = -6.41, SE ±3.9, t(30.9) = -1.23, p = .111, g = 0.497, Pre exercise mBESS (p = .253, g = -.322), Post exercise mBESS ( p = .223, g = -.344), Pre-exercise RT (p = .374, g = 0.245), and Post-exercise RT (p = .268, g = 0.308). CONCLUSION: Pre-Post exercise differences in PCSS were small. A majority (67%-77%) of athletes reported no change or a reduction in post exercise PCSS. Study limitations include exclusion of preseason PCSS, mBESS and RT baseline data for comparison and small sample size. Future studies should consider PCSS for multiple treadmill performances across the return to play trajectory.

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