389
Views
3
CrossRef citations to date
0
Altmetric
Research Article

Post-exercise cognitive testing to assess persisting alterations in athletes with a history of concussion

, , &
Pages 978-985 | Received 09 Jun 2020, Accepted 14 Jun 2021, Published online: 05 Jul 2021

References

  • Leddy JJ, Baker JG, Willer B. Active rehabilitation of concussion and post-concussion syndrome. Phys Med Rehabil Clin N Am. 2016;27(2):437–54. doi:10.1016/j.pmr.2015.12.003.
  • McIntyre M, Kempenaar A, Amiri M, Alavinia SM, Kumbhare D. The role of subsymptom threshold aerobic exercise for persistent concussion symptoms in patients with postconcussion syndrome. Am J Phys Med Rehabil. 2020;99(3):257–64. doi:10.1097/PHM.0000000000001340.
  • Leddy J, Baker JG, Haider MN, Hinds A, Willer B. A physiological approach to prolonged recovery from sport-related concussion. J Athl Train. 2017;52(3):299–308. doi:10.4085/1062-6050-51.11.08.
  • Marshall CM, Chan N, Tran P, DeMatteo C. The use of an intensive physical exertion test as a final return to play measure in concussed athletes: a prospective cohort. Phys Sportsmed. 2019;47(2):158–66. doi:10.1080/00913847.2018.1542258.
  • McGrath N, Dinn WM, Collins MW, Lovell MR, Elbin RJ, Kontos AP. Post-exertion neurocognitive test failure among student-athletes following concussion. Brain Inj. 2013;27(1):103–13. doi:10.3109/02699052.2012.729282.
  • Sicard V, Lortie JC, Moore RD, Ellemberg D. Cognitive testing and exercise to assess the readiness to return to play after a concussion. TJACSM. 2020;5(11):1–9.
  • McCrory P, Meeuwisse WH, Aubry M, Cantu RC, Dvorak J, Echemendia RJ, Engebretsen L, Johnston K, Kuther JS, Raftery M, et al. Consensus statement on concussion in sport: the 4th international conference on concussion in sport, Zurich, November 2012. J Athl Train. 2013;48(4):554–75. doi:10.4085/1062-6050-48.4.05.
  • McCrory P, Meeuwisse W, Dvorak J, Aubry M, Bailes S, Cantu RC, Cassidy D, Echemendia RJ, Castellani RJ, Davis GA, et al. Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med. 2017;51(11):838–47. doi:10.1136/bjsports-2017-097699.
  • Belanger HG, Spiegel E, Vanderploeg RD. Neuropsychological performance following a history of multiple self-reported concussions: a meta-analysis. J Int Neuropsychol Soc. 2010;16(2):262–67. doi:10.1017/S1355617709991287.
  • Sicard V, Moore RD, Ellemberg D. Long-term cognitive outcomes in male and female athletes following sport-related concussions. Int J Psychophysiol. 2018;132(Pt A):3–8. doi:10.1016/j.ijpsycho.2018.03.011.
  • Vynorius KC, Paquin AM, Seichepine DR. Lifetime multiple mild traumatic brain injuries are associated with cognitive and mood symptoms in young healthy college students. Front Neurol. 2016;7:188. doi:10.3389/fneur.2016.00188.
  • Moore DR, Pindus DM, Raine LB, Drollette ES, Scudder MR, Ellemberg D, Hillman CH. The persistent influence of concussion on attention, executive control and neuroelectric function in preadolescent children. Int J Psychophysiol. 2016;99:85–95. doi:10.1016/j.ijpsycho.2015.11.010.
  • Kumar S, Rao SL, Chandamouli BA, Pillai SV. Reduction of functional brain connectivity in mild traumatic brain injury during working memory. J Neurotrauma. 2009;26(5):665–75. doi:10.1089/neu.2008.0644.
  • Sicard V, Moore RD, Ellemberg D. Sensitivity of the Cogstate test battery for detecting prolonged cognitive alterations stemming from sport-related concussions. Clin J Sport Med. 2019;29(1):62–68. doi:10.1097/JSM.0000000000000492.
  • Ellemberg D, Leclerc S, Couture S, Daigle C. Prolonged neuropsychological impairments following a first concussion in female university soccer athletes. Clin J Sport Med. 2007;17(5):369–74. doi:10.1097/JSM.0b013e31814c3e3e.
  • Diamond A. Executive functions. Annu Rev Psychol. 2013;64(1):135–68. doi:10.1146/annurev-psych-113011-143750.
  • LeMonda BC, Tam D, Barr WB, Rabin LA. Assessment trends among neuropsychologists conducting sport-related concussion evalutions. Dev Psychol. 2017;42(2):113–266.
  • Allen BJ, Gfeller JD. The immediate post-concussion assessment and cognitive testing battery and traditional neuropsychological measures: a construct and concurrent validity study. Brain Inj. 2011;25(2):179–91. doi:10.3109/02699052.2010.541897.
  • Koehl LM, Walls BD, Brothers SL, Morris SN, Glueck AC, Schmitt FA, Berry DTR, Han DY. Convergent and discriminant validity of the Immediate Postconcussion Assessment and Cognitive Testing Battery (ImPACT) in young athletes. Appl Neuropsychol Child. 2018;8(3):1–11.
  • Maerlender A, Flashman L, Kessler A, Kumbhani S, Greenwald R, Tosteson T, McAllister T. Discriminant construct validity of ImPACT: a companion study. Clin Neuropsychol. 2013;27(2):290–99. doi:10.1080/13854046.2012.744098.
  • Bleiberg J, Kane RL, Reeves DL, Garmoe WS, Halpern E. Factor analysis of computerized and traditional tests used in mild brain injury research. Clin Neuropsychol. 2000;14(3):287–94. doi:10.1076/1385-4046(200008)14:3;1-P;FT287.
  • Maruff P, Thomas E, Cysique L, Brew B, Collie A, Snyder P, Pietrzak RH. Validity of the CogState brief battery: relationship to standardized tests and sensitivity to cognitive impairment in mild traumatic brain injury, schizophrenia, and AIDS dementia complex. Arch Clin Neuropsychol. 2009;24(2):165–78. doi:10.1093/arclin/acp010.
  • McGowan AL, Bretzin AC, Savage JL, Petit KM, Covassin T, Pontifex MB. Acute and protracted disruptions to inhibitory control following sports-related concussion. Neuropsychologia. 2019;131:223–32. doi:10.1016/j.neuropsychologia.2019.05.026.
  • McGowan AL, Bretzin AC, Savage JL, Petit KM, Parks AC, Covassin T, Pontifex MB. Preliminary evidence for differential trajectories of recovery for cognitive flexibility following sports-related concussion. Neuropsychology. 2018;32(5):564–74. doi:10.1037/neu0000475.
  • Moore RD, Hillman CH, Broglio SP. The persistent influence of concussive injuries on cognitive control and neuroelectric function. J Athl Train. 2014;49(1):24–35. doi:10.4085/1062-6050-49.1.01.
  • Monsell S. Task switching. Trends Cogn Sci. 2003;7(3):134–40. doi:10.1016/S1364-6613(03)00028-7.
  • Wylie G, Allport A. Task switching and the measurement of “switch costs.” Psychol Res. 2000;63(3–4):212–33. doi:10.1007/s004269900003.
  • Mayr U, LaRoux C, Rolheiser T, Osternig L, Chou L-S, van Donkelaar P, Gilbert S. Executive dysfunction assessed with a task-switching task following concussion. PLoS One. 2014;9(3):e91379. doi:10.1371/journal.pone.0091379.
  • Howell D, Osternig L, van Donkelaar P, Mayr U, Chou LS. Effects of concussion on attention and executive function in adolescents. Med Sci Sports Exerc. 2013;45(6):1030–37. doi:10.1249/MSS.0b013e3182814595.
  • Pruna R, Bahdur K. Cognitive skills of elite football players are essential for developing high efficiency and reduce recovery time after an injury. Int Orthop. 2016;3(1):503–04. doi:10.17554/j..2311-5106.2016.03.154.
  • Brooks MA, Peterson K, Biese K, Sanfilippo J, Heiderscheit BC, Bell DR. Concussion increases odds of sustaining a lower extremity musculoskeletal injury after return to play among collegiate athletes. Am J Sports Med. 2016;44(3):742–47. doi:10.1177/0363546515622387.
  • Lynall RC, Mauntel TC, Padua DA, Mihalik JP. Acute lower extremity injury rates increase after concussion in college athletes. Med Sci Sports Exerc. 2015;47(12):2487–92. doi:10.1249/MSS.0000000000000716.
  • Lynall RC, Mauntel TC, Pohlig RT, Kerr ZY, Dompier TP, Hall EE, Buckley TA. Lower extremity musculoskeletal injury risk after concussion recovery in high school athletes. J Athl Train. 2017;52(11):1028–34. doi:10.4085/1062-6050-52.11.22.
  • Petushek EJ, Cokely ET, Ward P, Myer GD. Injury risk estimation expertise: cognitive-perceptual mechanisms of ACL-IQ. J Sport Exerc Psychol. 2015;37(3):291–304. doi:10.1123/jsep.2014-0315.
  • Mcpherson A, Nagai T, Wbster KE, Heweet TE. Risk of lower extremity musculoskeletal injury after concussion: a meta-analysis. 2018;50(5S):2.
  • McPherson AL, Nagai T, Webster KE, Hewett TE. Musculoskeletal injury risk after sport-related concussion: a systematic review and meta-analysis. Am J Sports Med. 2019;47(7):1754–62. doi:10.1177/0363546518785901.
  • McCrea M, Guskiewicz K, Randolph C, Barr WB, Hammeke TA, Marshall SQ, Kelly JP. Effects of a symptom-free waiting period on clinical outcome and risk of reinjury after sport-related concussion. Neurosurgery. 2009;65(5):876–82. doi:10.1227/01.NEU.0000350155.89800.00.
  • McCrory PR.Were you knocked out? A team physician’s approach to initial concussion management. Med Sci Sports Exerc. 1997;29(7 Suppl):S207–12. doi:10.1097/00005768-199707001-00002.
  • Gellish RL, Goslin BR, Olson RE, McDonald A, Russi GD, Moudgil VK. Longitudinal modeling of the relationship between age and maximal heart rate. Med Sci Sports Exerc. 2007;39(5):822–29. doi:10.1097/mss.0b013e31803349c6.
  • Hanson P. Clinical exercise training. sport medicine. Strauss R, ed. Philadelphia, PA: W.B. Saunders Company; 1984.
  • Chang YK, Labban JD, Gapin JI, Etnier JL. The effects of acute exercise on cognitive performance: a meta-analysis. Brain Res. 2012;1453:87–101. doi:10.1016/j.brainres.2012.02.068.
  • Lambourne K, Tomporowski P. The effect of exercise-induced arousal on cognitive task performance: a meta-regression analysis. Brain Res. 2010;1341:12–24. doi:10.1016/j.brainres.2010.03.091.
  • Sicard V, Simard A, Moore RD, Lavoie G, Ellemberg D. Psychometric properties of a color-shape version of the switch task. Appl Neuropsychol Adult. 2020 Dec;9:1–10. doi:10.1080/23279095.2020.1842410.
  • Sicard V, Simard A, Moore RD, Ellemberg D. Practice effect associated with the serial administration of the switch task and its implications in the assessment of sports-related concussion. J Clin Exp Neuropsychol. 2020;42(9):965–73. doi:10.1080/13803395.2020.1828836.
  • Militana AR, Donahue MJ, Sills AK, Solomon GS, Gregory AJ, Strother MK, Morgan VL. Alterations in default-mode network connectivity may be influenced by cerebrovascular changes within 1 week of sports related concussion in college varsity athletes: a pilot study. Brain Imaging Behav. 2016;10(2):559–68. doi:10.1007/s11682-015-9407-3.
  • Meier TB, Bellgowan PS, Mayer AR. Longitudinal assessment of local and global functional connectivity following sports-related concussion. Brain Imaging Behav. 2016;11(1):129–40.
  • Gomez-Pinilla F, Feng C.. Molecular mechanisms for the ability of exercise supporting cognitive abilities and counteracting neurological disorders. In: Boecker H, Hillman CH, Scheef L, Struder HK, editors. Functional neuroimaging in exercise and sport sciences. New-York: Springer; 2012. p. 25–43.
  • Meier TB, Bellgowan PS, Singh R, Kyplick R, Polanski DW, Mayer AR. Recovery of cerebral blood flow following sports-related concussion. JAMA Neurol. 2015;72(5):530–38. doi:10.1001/jamaneurol.2014.4778.
  • Gardner AJ, Tan CO, Ainslie PN, van Donkelaar P, Stanwell P, Levi C, Iverson GL. Cerebrovascular reactivity assessed by transcranial Doppler ultrasound in sport-related concussion: a systematic review. Br J Sports Med. 2015;49(16):1050–55. doi:10.1136/bjsports-2014-093901.
  • Clausen M, Pendergast DR, Willer B, Leddy J. Cerebral blood flow during treadmill exercise is a marker of physiological postconcussion syndrome in female athletes. J Head Trauma Rehabil. 2016;31(3):215–24. doi:10.1097/HTR.0000000000000145.
  • Czerniak SM, Sikoglu EM, Liso Navarro AA, McCafferty J, Eisenstock J, Stevenson JH, King JA, Moore CM. A resting state functional magnetic resonance imaging study of concussion in collegiate athletes. Brain Imaging Behav. 2015;9(2):323–32. doi:10.1007/s11682-014-9312-1.
  • Meier TB, Bellgowan PSF, Mayer AR. Longitudinal assessment of local and global functional connectivity following sports-related concussion. Brain Imaging Behav. 2017;11(1):129–40. doi:10.1007/s11682-016-9520-y.
  • Gardner AJ, Tan CO, Ainslie PN, van Donkelaar P, Stanwell P, Levi CR, Iverson GL. Cerebrovascular reactivity assessed by transcranial Doppler ultrasound in sport-related concussion: a systematic review. Br J Sports Med. 2015;49(16):1050–55.
  • Maugans TA, Farley C, Altaye M, Leach J, Cecil KM. Pediatric sports-related concussion produces cerebral blood flow alterations. Pediatrics. 2012;129(1):28–37. doi:10.1542/peds.2011-2083.
  • Meier TB, Bellgowan PSF, Singh R, Kuplicki R, Polanski DW, Mayer AR. Recovery of cerebral blood flow following sports-related concussion. JAMA Neurol. 2015;72(5):530–38.
  • Archer T, Svensson K, Alricsson M. Physical exercise ameliorates deficits induced by traumatic brain injury. Acta Neurol Scand. 2012;125(5):293–302. doi:10.1111/j.1600-0404.2011.01638.x.
  • Clausen M, Pendergast DR, Willer B, Leddy JJ. Cerebral blood flow during treadmill exercise is a marker of physiological postconcussion syndrome in female athletes. J Head Trauma Rehabil. 2016;31(3):215–24.
  • Leddy JJ, Baker JG, Haider MN, Hinds A, Willer B. A physiological approach to prolonged recovery from sport-related concussion. J Athl Train. 2017;52(3):299–308.
  • Kozlowski K, Graam J, Leddy JJ, Devinney-Boymel L, Willer BS. Exercise intolerance in individuals with postconcussion syndome. J Athl Train. 2013;48(5):627–35. doi:10.4085/1062-6050-48.5.02.
  • Gomez-Pinilla F, Feng C. Molecular mechanisms for the ability of exercise supporting sognitive abilities and counteracting neurological disorders. In: Boecker H, Hillman CH, Scheef L, Struder K, editors. Functional neuroimaging in exercise and sport sciences. New-York: Springer; 2012. p. 25–43.
  • Ferris LT, Williams JS, Shen C-L. The effect of acute exercise on serum brain-derived neurotrophic factor levels and cognitive function. Med Sci Sports Exerc. 2007;39(4):728–34. doi:10.1249/mss.0b013e31802f04c7.
  • Gold SM, Schulz KH, Hartmann S, Mladek M, Lang UE, Hellweg R, Reer R, Braumann KM, Heesen C. Basal serum levels and reactivity of nerve growth factor and brain-derived neurotrophic factor to standardized acute exercise in multiple sclerosis and controls. J Neuroimmunol. 2003;138(1–2):99–105. doi:10.1016/S0165-5728(03)00121-8.
  • Bergsneider M, Hovda DA, Lee SM, Kelly DF, McArthur DL, Vespa PM, Lee JH, Huang S-C, Martin NA, Phelps ME, et al. Dissociation of cerebral glucose metabolism and level of consciousness during the period of metabolic depression following human traumatic brain injury. J Neurotrauma. 2000;17(5):389–401. doi:10.1089/neu.2000.17.389.
  • Abbas K, Shenk TE, Poole VN, Breedlove EL, Leverenz LJ, Nauman EA, Talavage TM, Robinson ME. Alteration of default mode network in high school football athletes due to repetitive subconcussive mild traumatic brain injury: a resting-state functional magnetic resonance imaging study. Brain Connect. 2015;5(2):91–101. doi:10.1089/brain.2014.0279.
  • Czerniak SM, Sikoglu EM, Liso NAA, McCafferty J, Eisenstock J, Stevenson JH, King JA, Moore CM. A resting state functional magnetic resonance imaging study of concussion in collegiate athletes. Brain Imaging Behav. 2015;9(2):323–32.
  • Slobounov SM, Zhang K, Pennell D, Ray W, Johnson B, Sebastianelli W. Functional abnormalities in normally appearing athletes following mild traumatic brain injury: a functional MRI study. Exp Brain Res. 2010;202(2):341–54. doi:10.1007/s00221-009-2141-6.
  • Dietrich A. Transient hypofrontality as a mechanism for the psychological effects of exercise. Psychiatry Res. 2006;145(1):79–83. doi:10.1016/j.psychres.2005.07.033.
  • Liu K, Li B, Qian S, Jiang Q, Li L, Wang W, Zhang G, Sun Y, Sun G. Mental fatigue after mild traumatic brain injury: a 3D-ASL perfusion study. Brain Imaging Behav. 2016;10(3):857–68. doi:10.1007/s11682-015-9492-3.
  • Kohl AD, Wylie GR, Genova HM, Hillary FG, Deluca J. The neural correlates of cognitive fatigue in traumatic brain injury using functional MRI. Brain Inj. 2009;23(5):420–32. doi:10.1080/02699050902788519.
  • McAllister TW, Sparling MB, Flashman LA, Guerin SJ, Mamourian AC, Saykin AJ. Differential working memory load effects after mild traumatic brain injury. Neuroimage. 2001;14(5):1004–12. doi:10.1006/nimg.2001.0899.
  • Nordin LE, Moller MC, Julin P, Bartfai A, Hashim F, Li T-Q. Post mTBI fatigue is associated with abnormal brain functional connectivity. Sci Rep. 2016;6(1):21183. doi:10.1038/srep21183.
  • Ziino C, Ponsford J. Vigilance and fatigue following traumatic brain injury. J Int Neuropsychol Soc. 2006;12(1):100–10. doi:10.1017/S1355617706060139.
  • Kluger BM, Krupp LB, Enoka RM. Fatigue and fatigability in neurologic illnesses: proposal for a unified taxonomy. Neurology. 2003;80(4):409–16. doi:10.1212/WNL.0b013e31827f07be.
  • Maerlender A, Flashman L, Kessler A, Kumbhani S, Greenwald R, Tosteson T, McAllister T. Discriminant construct validity of impact™: a companion study. Clin Neuropsychol. 2013;27(2):290–99.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.