Measurement of improvement on repeat exercise intolerance testing for suspected dysautonomia in protracted concussion recovery: a retrospective cohort study

References

• Baker JG, Freitas MS, Leddy JJ, Kozlowski KF, Willer BS 2012 Return to full functioning after graded exercise assessment and progressive exercise treatment of postconcussion syndrome. Rehabilitation Research and Practice 2012: 705309. doi:10.1155/2012/705309.
   PubMedGoogle Scholar
• Bellenger CR, Fuller JT, Thomson RL, Davison K, Robertson EY, Buckley JD 2016 Monitoring athletic training status through autonomic heart rate regulation: A systematic review and meta-analysis. Sports Medicine 46(10): 1461–1486. doi:10.1007/s40279-016-0484-2.
   PubMed Web of Science ®Google Scholar
• Borg G 1998 Borg’s perceived exertion and pain scales. Champaign, IL: Human Kinetics.
   Google Scholar
• Callaway C, Kosofsky BE 2019 Autonomic dysfunction following mild traumatic brain injury. Current Opinion in Neurology 32(6): 802–807. doi:10.1097/WCO.0000000000000751.
   PubMed Web of Science ®Google Scholar
• Clausen M, Pendergast DR, Willer B, Leddy J 2016 Cerebral blood flow during treadmill exercise is a marker of physiological postconcussion syndrome in female athletes. Journal of Head Trauma Rehabilitation 31(3): 215–224. doi:10.1097/HTR.0000000000000145.
   PubMed Web of Science ®Google Scholar
• Cordingley D, Girardin R, Reimer K, Ritchie L, Leiter J, Russell K, Ellis MJ 2016 Graded aerobic treadmill testing in pediatric sports-related concussion: Safety, clinical use, and patient outcomes. Journal of Neurosurgery. Pediatrics 25(6): 693–702. doi:10.3171/2016.5.PEDS16139.
   PubMedGoogle Scholar
• Faul F, Erdfelder E, Lang AG, Buchner A 2007 G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods 39(2): 175–191. doi:10.3758/BF03193146.
   PubMed Web of Science ®Google Scholar
• Gall B, Parkhouse W, Goodman D 2004 Heart rate variability of recently concussed athletes at rest and exercise. Medicine and Science in Sports and Exercise 36(8): 1269–1274. doi:10.1249/01.MSS.0000135787.73757.4D.
   PubMed Web of Science ®Google Scholar
• Haider MN, Nowak A, Sandhur M, Leddy JJ 2022 Sport-related concussion and exercise intolerance. Operative Techniques in Sports Medicine 30(1): 150895. doi:10.1016/j.otsm.2022.150895.
   Web of Science ®Google Scholar
• Iverson GL, Brooks BL, Collins MW, Lovell MR 2006 Tracking neuropsychological recovery following concussion in sport. Brain Injury 20(3): 245–252. doi:10.1080/02699050500487910.
   PubMed Web of Science ®Google Scholar
• Kozlowski KF, Graham J, Leddy JJ, Devinney-Boymel L, Willer BS 2013 Exercise intolerance in individuals with postconcussion syndrome. Journal of Athletic Training 48(5): 627–635. doi:10.4085/1062-6050-48.5.02.
   PubMed Web of Science ®Google Scholar
• Lawrence DW, Richards D, Comper P, Hutchison MG 2018 Earlier time to aerobic exercise is associated with faster recovery following acute sport concussion. PLoS One 13(4): e0196062. doi:10.1371/journal.pone.0196062.
   PubMed Web of Science ®Google Scholar
• Leddy JJ, Baker JG, Haider MN, Hinds A, Willer B 2017 A physiological approach to prolonged recovery from sport-related concussion. Journal of Athletic Training 52(3): 299–308. doi:10.4085/1062-6050-51.11.08.
   PubMed Web of Science ®Google Scholar
• Leddy JJ, Baker JG, Kozlowski K, Bisson L, Willer B 2011 Reliability of a graded exercise test for assessing recovery from concussion. Clinical Journal of Sports Medicine 21(2): 89–94. doi:10.1097/JSM.0b013e3181fdc721.
   PubMed Web of Science ®Google Scholar
• Leddy JJ, Baker JG, Merchant A, Picano J, Gaile D, Matuszak J, Willer B 2015 Brain or strain? Symptoms alone do not distinguish physiologic concussion from cervical/vestibular injury. Clinical Journal of Sports Medicine 25(3): 237–242. doi:10.1097/JSM.0000000000000128.
   PubMed Web of Science ®Google Scholar
• Leddy JJ, Haider MN, Ellis MJ, Mannix R, Darling SR, Freitas MS, Suffoletto HN, Leiter J, Cordingley DM, Willer B 2019 Early subthreshold aerobic exercise for sport-related concussion: A randomized clinical trial. JAMA Pediatrics 173(4): 319–325. doi:10.1001/jamapediatrics.2018.4397.
   PubMed Web of Science ®Google Scholar
• Leddy JJ, Haider MN, Noble JM, Rieger B, Flanagan S, McPherson J, Shubin-Stein K, Saleem G, Corsaro L, Willer B 2021 Management of concussion and persistent post-concussive symptoms for neurologists. Current Neurology and Neuroscience Reports 21(12): 72. doi:10.1007/s11910-021-01160-9.
   PubMed Web of Science ®Google Scholar
• Leddy JJ, Hinds AL, Miecznikowski J, Darling S, Matuszak J, Baker JG, Picano J, Willer B 2018 Safety and prognostic utility of provocative exercise testing in acutely concussed adolescents: A randomized trial. Clinical Journal of Sport Medicine 28(1): 13–20. doi:10.1097/JSM.0000000000000431.
   PubMed Web of Science ®Google Scholar
• Leddy JJ, Kozlowski K, Donnelly JP, Pendergast DR, Epstein LH, Willer B 2010 A preliminary study of subsymptom threshold exercise training for refractory post-concussion syndrome. Clinical Journal of Sport Medicine 20(1): 21–27. doi:10.1097/JSM.0b013e3181c6c22c.
   PubMed Web of Science ®Google Scholar
• Leddy JJ, Kozlowski K, Fung M, Pendergast DR, Willer B 2007 Regulatory and autoregulatory physiological dysfunction as a primary characteristic of post concussion syndrome: Implications for treatment. NeuroRehabilitation 22(3): 199–205. doi:10.3233/NRE-2007-22306.
   PubMed Web of Science ®Google Scholar
• Leddy JJ, Willer B 2013 Use of graded exercise testing in concussion and return-to-activity management. Current Sports Medicine Reports 12(6): 370–376. doi:10.1249/JSR.0000000000000008.
   PubMed Web of Science ®Google Scholar
• McCrory P, Meeuwisse WH, Aubry M, Cantu B, Dvorák J, Echemendia RJ, Engebretsen L, Johnston K, Kutcher JS, Raftery M, et al. 2013 Consensus statement on concussion in sport: The 4th international conference on concussion in sport held in Zurich, November 2012. British Journal Sports Medicine 47: 250–258.
   PubMed Web of Science ®Google Scholar
• Miranda NA, Boris JR, Kouvel KM, Stiles L 2018 Activity and exercise intolerance after concussion: Identification and management of postural orthostatic tachycardia syndrome. Journal of Neurologic Physical Therapy 42(3): 163–171. doi:10.1097/NPT.0000000000000231.
   PubMed Web of Science ®Google Scholar
• National Institute of Neurological Disorders and Stroke 2019 Dysautonomia information page. Bethesda, MD: National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/All-Disorders/Dysautonomia-Information-Page
   Google Scholar
• Ontario Neurotrauma Foundation 2018 Guideline for concussion/Mild Traumatic Brain Injury and persistent symptoms. https://braininjuryguidelines.org/concussion/fileadmin/Guidelines_components/12sections/Section-3.pdf
   Google Scholar
• Pertab JL, Merkley TL, Cramond AJ, Cramond K, Paxton H, Wu T 2018 Concussion and the autonomic nervous system: An introduction to the field and the results of a systematic review. NeuroRehabilitation 42(4): 397–427. doi:10.3233/NRE-172298.
   PubMed Web of Science ®Google Scholar
• Peterson AB, Zhou H, Thomas KE, Daugherty J 2021 Surveillance Report of Traumatic Brain Injury-Related hospitalizations and deaths by age group, sex, and mechanism of injury. United States 2016-2017. Centers for Disease Control and Prevention. https://stacks.cdc.gov/view/cdc/111900
   Google Scholar
• Quatman-Yates CC, Hunter-Giordano A, Shimamura KK, Landel R, Alsalaheen BA, Hanke TA, McCulloch KL, Altman RD, Beattie P, Berz KE 2020 Physical therapy evaluation and treatment after concussion/mild traumatic brain injury. Journal of Orthopaedic and Sports Physical Therapy 50(4): 1–73. doi:10.2519/jospt.2020.0301.
   PubMed Web of Science ®Google Scholar
• Reichgott MJ 1990 Clinical evidence of dysautonomia. In: Walker HK, Hall W, Hurst JW (Eds) Clinical methods: The history, physical, and laboratory examinations 3rd, p. 389–397. Boston, MA: Butterworths.
   Google Scholar
• Ziaks L, Brown C, Iversen M 2021 Physical examination findings in patients with protracted concussion and the impact of an integrative concussion rehabilitation protocol. Internet Journal of Allied Health Sciences and Practice 19: 6.
   Web of Science ®Google Scholar
• Ziaks L, Tucker J, Koc T, Schaefer A, Hanson K 2022 Identifying trends of dysautonomia signs and symptoms associated with protracted concussion recovery during the Buffalo concussion treadmill test: A retrospective study. Brain Impairment 1–10. Online ahead of print. doi:10.1017/BrImp.2022.5.
   PubMed Web of Science ®Google Scholar