Does early exercise intolerance effect time to return to play, symptom burden, neurocognition, Vestibular-Ocular-Motor (VOM) function and academic ability in acutely concussed student-athletes?

References

• Giza CC, Hovda DA. The new neurometabolic cascade of concussion. Neurosurgery. 2014 [cited 2022 Jun 15];75(Supplement 4):S24–33. doi:10.1227/NEU.0000000000000505.
   PubMedGoogle Scholar
• Patricios JS, Schneider KJ, Dvorak J, Ahmed OH, Blauwet C, Cantu RC, Davis GA, Echemendia RJ, Makdissi M, McNamee M, et al. Consensus statement on concussion in sport: the 6th international conference on concussion in sport–Amsterdam, October 2022. Br J Sports Med. 2023;57(11):695–711. doi:10.1136/bjsports-2023-106898.
   PubMed Web of Science ®Google Scholar
• Johnson VE, Stewart W, Smith DH. Axonal pathology in traumatic brain injury. Exp Neurol. 2013;246:35–43. doi:10.1016/j.expneurol.2012.01.013.
   PubMed Web of Science ®Google Scholar
• Ellis MJ, Leddy JJ, Willer B. Physiological, vestibulo-ocular and cervicogenic post-concussion disorders: an evidence-based classification system with directions for treatment. Brain Inj. 2015;29(2):238–48. doi:10.3109/02699052.2014.965207.
   PubMed Web of Science ®Google Scholar
• Giza C, Greco T, Prins ML. Concussion: pathophysiology and clinical translation. Handb Clin Neurol. 2018;158:51–61.
   PubMedGoogle Scholar
• Pertab JL, Merkley TL, Cramond AJ, Cramond K, Paxton H, Wu T. Concussion and the autonomic nervous system: an introduction to the field and the results of a systematic review. NeuroRehabilitation. 2018;42(4):397–427. doi:10.3233/NRE-172298.
   PubMed Web of Science ®Google Scholar
• Laskowski RA, Creed JA, Raghupathi R. Brain Neurotrauma: Mol Neuropsychological Rehabil Aspects, Kobeissy FH, editor. Boca Raton (FL): CRC Press/Taylor & Francis. 2015:35–42. ( Frontiers in Neuroengineering).
   Google Scholar
• La Fountaine MF, Hohn AN, Testa AJ, Weir JP. Attenuation of spontaneous baroreceptor sensitivity after concussion. Med Sci Sports Exccise. [2019 Apr 1];51(4):792–97. doi:10.1249/MSS.0000000000001833.
   Web of Science ®Google Scholar
• Leddy JJ, Hinds AL, Miecznikowski J, Darling S, Matuszak J, Baker JG, Picano, J. Willer, B. Safety and prognostic utility of provocative exercise testing in acutely concussed adolescents: a randomized trial. Clin J Sport Med. 2018;28(1):13–20. doi:10.1097/JSM.0000000000000431.
   PubMed Web of Science ®Google Scholar
• 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. doi:10.4085/1062-6050-51.11.08.
   PubMed Web of Science ®Google Scholar
• Leddy JJ, Burma JS, Toomey CM, Hayden A, Davis GA, Babl FE, Gagnon I, Giza CC, Kurowski BG, Silverberg ND, et al. Rest and exercise early after sport-related concussion: a systematic review and meta-analysis. Br J Sports Med. 2023;57(12):762–70. doi:10.1136/bjsports-2022-106676.
   Web of Science ®Google Scholar
• Leddy JJ, Cox JL, Baker JG, Wack DS, Pendergast DR, Zivadinov R, Willer, B. Exercise treatment for postconcussion syndrome: a pilot study of changes in functional magnetic resonance imaging activation, physiology, and symptoms. J Head Trauma Rehabil. 2013 Jul;28(4):241–49. doi:10.1097/HTR.0b013e31826da964.
   PubMed Web of Science ®Google Scholar
• Miranda NA, Boris JR, Kouvel KM, Stiles L. Activity and exercise intolerance after concussion: identification and management of postural orthostatic tachycardia syndrome. J Neurol Phys Ther. 2018;42(3):163–71. doi:10.1097/NPT.0000000000000231.
   PubMed Web of Science ®Google Scholar
• 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. doi:10.1097/HTR.0000000000000145.
   PubMed Web of Science ®Google Scholar
• Gall B, Parkhouse W, Goodman D. Heart rate variability of recently concussed athletes at rest and exercise. Med Sci Sports Exccise. 2004;36(8):1269–74. doi:10.1249/01.MSS.0000135787.73757.4D.
   PubMed Web of Science ®Google Scholar
• Gall B, Parkhouse W, Goodman D. Exercise following a sport induced concussion. Br J Sports Med. 2004;38(6):773–77. doi:10.1136/bjsm.2003.009530.
   PubMed Web of Science ®Google Scholar
• Harrison A, Lane-Cordova A, La Fountaine MF, Moore RD. Concussion history and heart rate variability during bouts of acute stress. J Athl Train. 2022;57(8):741–47. doi:10.4085/1062-6050-0314.21.
   Web of Science ®Google Scholar
• Howell DR, Hunt DL, Aaron SE, Hamner JW, Meehan WP, Tan CO. Association of hemodynamic and cerebrovascular responses to exercise with symptom severity in adolescents and young adults with concussion. Neurology. 2021 30;97(22):e2204–12. doi:10.1212/WNL.0000000000012929.
   PubMed Web of Science ®Google Scholar
• Kozlowski KF, Graham J, Leddy JJ, Devinney-Boymel L, Willer BS. Exercise intolerance in individuals with postconcussion syndrome. J Athl Train. 2013 Sep;48(5):627–35. doi:10.4085/1062-6050-48.5.02.
   PubMed Web of Science ®Google Scholar
• Worts PR, Mason JR, Burkhart SO, Sanchez-Gonzalez MA, Kim J-S. The acute, systemic effects of aerobic exercise in recently concussed adolescent student-athletes: preliminary findings. Eur J Appl Physiol. 2022 Jun 18;122(6):1441–57. doi:10.1007/s00421-022-04932-4.
   PubMed Web of Science ®Google Scholar
• Haider MN, Johnson SL, Mannix R, Macfarlane AJ, Constantino D, Johnson BD, Willer B, Leddy J. The buffalo concussion bike test for concussion assessment in adolescents. Sport Heal A Multidiscip Approach. 2019 Nov 5;11(6):492–97. doi:10.1177/1941738119870189.
   Web of Science ®Google Scholar
• Lalji R, Hincapié CA, Macpherson A, Howitt S, Marshall C, Tamim H. Association between first attempt buffalo concussion treadmill test and days to recovery in 855 children with sport-related concussion: a historical cohort study and prognostic factors analysis. Clin J Sport Med. 2023 Sep 7;33(5):505–11. doi:10.1097/JSM.0000000000001134.
   Web of Science ®Google Scholar
• Orr R, Bogg T, Fyffe A, Lam LT, Browne GJ. Graded exercise testing predicts recovery trajectory of concussion in children and adolescents. Clin J Sport Med Off J Can Acad Sport Med. 2018;31(1):23–30. doi:10.1097/JSM.0000000000000683.
   Google Scholar
• Polak P, Leddy JJ, Dwyer MG, Willer B, Zivadinov R. Diffusion tensor imaging alterations in patients with postconcussion syndrome undergoing exercise treatment: A pilot longitudinal study. J Head Trauma Rehabil. 2015 Mar 1;30(2):E32–42. doi:10.1097/HTR.0000000000000037.
   PubMed Web of Science ®Google Scholar
• Leddy JJ, Wilber CG, Willer BS. Active recovery from concussion. Curr Opin Neurol. 2018;31(September):1. doi:10.1097/WCO.0000000000000611.
   Google Scholar
• Tahouni Y, Cheng T, Lajewski S, Benz J, Bonten C, Wood D, Menges A. Codesign of biobased cellulose-filled filaments and mesostructures for 4d printing humidity responsive smart structures. 3D Print Addit Manuf. 2023 Feb 1;10(1):1–14. doi:10.1089/3dp.2022.0061.
   Google Scholar
• Schneider KJ. Concussion – part I: the need for a multifaceted assessment. Musculoskelet Sci Pract. 2019 Jul 1;42:140–50. doi:10.1016/j.msksp.2019.05.007.
   PubMed Web of Science ®Google Scholar
• Mucha A, Collins MW, Elbin RJ, Furman JM, Troutman-Enseki C, DeWolf RM, Marchetti G, Kontos AP. A brief vestibular/ocular motor screening (VOMS) assessment to evaluate concussions: preliminary findings. Am J Sports Med. 2014;42(10):2479–86. doi:10.1177/0363546514543775.
   PubMed Web of Science ®Google Scholar
• Schatz P, Pardini JE, Lovell MR, Collins MW, Podell K. Sensitivity and specificity of the ImPACT test battery for concussion in athletes. Arch Clin Neuropsychol. 2006;21(1):91‐99. doi:10.1016/j.acn.2005.08.001.
   Web of Science ®Google Scholar
• Iverson GL, Lovell MR, Collins MW, Lovell MR, C MW, Iverson GL. Interpreting change on ImPACT following sport concussion. Clin Neuropsychol. 2003 Nov 9 [cited 2019 Mar 19];17(4):460–67. doi:10.1076/clin.17.4.460.27934.
   PubMed Web of Science ®Google Scholar
• Lovell MR, Iverson GL, Collins MW. Validity of ImPACT for measuring processing speed following sports-related concussion. J Clin Exp Neuropsychol. 2005 Aug;27(6):683–89. doi:10.1081/13803390490918435.
   PubMed Web of Science ®Google Scholar
• Glendon K, Pain MTG, Belli A, Blenkinsop G. The revised perceived academic impact tool (PAIT2): a tool to assess academic dysfunction in university-aged student-athletes with Sports-related concussion (SRC). J Eur Sport Sci. 2023; 24(5):537–48. ahead of p. doi:10.1002/ejsc.12051.
   Web of Science ®Google Scholar
• Glendon K, Desai A, Blenkinsop G, Belli A, Pain M. Recovery of symptoms, neurocognitive and vestibular-ocular-motor function and academic ability after sports-related concussion (SRC) in university-aged student-athletes: a systematic review. Brain Inj. 2022 Mar;36(4):455–68. doi:10.1080/02699052.2022.2051740.
   PubMed Web of Science ®Google Scholar
• Glendon K, Blenkinsop G, Belli A, Pain M. Does vestibular-ocular-motor (VOM) impairment affect time to return to play, symptom severity, neurocognition and academic ability in Student-athletes following acute concussion? Brain Inj. 2021;35(7):788–97. doi:10.1080/02699052.2021.1911001.
   PubMed Web of Science ®Google Scholar
• Wasserman EB, Bazarian JJ, Mapstone M, Block R, Van Wijngaarden E. Academic dysfunction after a concussion among us high school and college students. Am J Public Health. 2016;106(7):1247–53. http://www.ncbi.nlm.nih.gov/pubmed/27196651.
   Web of Science ®Google Scholar
• Leddy JJ, Haider MN, Ellis MJ, Willer BS. Exercise is medicine for concussion. Curr Sports Med Rep. 2018;17(8):262–70. doi:10.1249/JSR.0000000000000505.
   PubMed Web of Science ®Google Scholar
• England Rugby. Adult Concussion Mnagement Guidelines. Adult Concussion Management Guidelines.pdf. 2019 [cited 2020 June 18]; Available from. https://www.englandrugby.com/b60e6e31-e1cd-4d88-a268-4b6e76fb6593//dxdam/86/86c7a5b7-e65a-4f58-ae9c-3c3c1449b519/HEADCASE.
   Google Scholar
• Makdissi M, Davis G, Jordan B, Patricios J, Purcell L, Putukian M. Revisiting the modifiers: how should the evaluation and management of acute concussions differ in specific groups? Br J Sports Med. 2013 Apr 11;47(5):314–20. doi:10.1136/bjsports-2013-092256.
   Web of Science ®Google Scholar
• Gaudet CE, Weyandt LL. Immediate post-concussion and cognitive testing (ImPACT): a systematic review of the prevalence and assessment of invalid performance. Clin Neuropsychol. 2017;31(1):43–58. doi:10.1080/13854046.2016.1220622.
   PubMed Web of Science ®Google Scholar
• Haider MN, Leddy JJ, Wilber CG, Viera KB, Bezherano I, Wilkins KJ, Miecznikowski JC, Willer BS. The predictive capacity of the buffalo concussion treadmill test after sport-related concussion in adolescents. Front Neurol. 2019;10(APR):395. doi:10.3389/fneur.2019.00395.
   Google Scholar
• Quatman-Yates C, Bailes A, Constand S, Sroka MC, Nissen K, Kurowski B, Hugentobler J. Exertional tolerance assessments after mild traumatic brain injury: a systematic review. Archiv Phy Med Rehabil. 2018 May;99(5):994–1010. doi:10.1016/j.apmr.2017.11.012.
   PubMed Web of Science ®Google Scholar
• Park K, Ksiazek T, Olson B, Park Tkbo K, Park K, Ksiazek T. Effectiveness of vestibular rehabilitation therapy for treatment of concussed adolescents with persistent symptoms of dizziness and imbalance. J Sport Rehabil. 2018;27(5):485–90. doi:10.1123/jsr.2016-0222.
   PubMed Web of Science ®Google Scholar
• Guazzi M, Arena R, Halle M, Piepoli MF, Myers J, Lavie CJ. 2016 focused update: clinical recommendations for cardiopulmonary exercise testing data assessment in specific patient populations. Circulation. 2016 Jun 14;133(24):e694–711. doi:10.1161/CIR.0000000000000406.
   PubMed Web of Science ®Google Scholar
• Dave U, Kinderknecht J, Cheng J, Santiago K, Jivanelli B, Ling DI. Systematic review and meta-analysis of sex-based differences for concussion incidence in soccer. Phys Sportsmed. 2022;50(1):11–19. doi:10.1080/00913847.2020.1868955.
   PubMed Web of Science ®Google Scholar
• Caccese JB, Buckley TA, Tierney RT, Rose WC, Glutting JJ, Kaminski TW. Sex and age differences in head acceleration during purposeful soccer heading. Res Sport Med. 2018;26(1):64–74. doi:10.1080/15438627.2017.1393756.
   PubMed Web of Science ®Google Scholar
• Ono KE, Burns TG, Bearden DJ, Sm M, King H, Reisner A. Sex-based differences as a predictor of recovery trajectories in young athletes after a sports-related concussion. Am J Sports Med. 2016;44(3):748–52. doi:10.1177/0363546515617746.
   PubMed Web of Science ®Google Scholar
• Schallmo MS, Weiner JA, Hsu WK. Sport and sex-specific reporting trends in the epidemiology of concussions sustained by high school athletes. J Bone Joint Surg Am. 2017;99(15):1314–20. doi:10.2106/JBJS.16.01573.
   PubMed Web of Science ®Google Scholar
• Covassin T, Elbin RJ. The female athlete: the role of gender in the assessment and management of sport-related concussion. Clin Sports Med. 2011;30(1):125–31. doi:10.1016/j.csm.2010.08.001.
   PubMed Web of Science ®Google Scholar
• Harmon KG, Drezner JA, Gammons M, Guskiewicz KM, Halstead M, Herring SA, Kutcher JS, Pana A, Putukian M, Roberts WO, et al. American medical society for sports medicine position statement: concussion in sport. Br J Sports Med. 2013;47(1):15–26. doi:10.1136/bjsports-2012-091941.
   PubMed Web of Science ®Google Scholar
• Daneshvar DH, Nowinski CJ, Mckee AC, Cantu RC. The epidemiology of sport-related concussion. Clin Sports Med. 2011 Jan;30(1):1–17. doi:10.1016/j.csm.2010.08.006.
   PubMed Web of Science ®Google Scholar
• Czerniak LL, Liebel SW, G-GPGP G, Lavieri MS, McCrea MA, McAllister TW, Broglio SP. Sensitivity and Specificity of computer-based neurocognitive tests in sport-related concussion: Findings from the NCAA-DoD CARE consortium. Sport Med. 2021;51(2):351–65. doi:10.1007/s40279-020-01393-7.
   Web of Science ®Google Scholar
• Reniers RLEP, Murphy L, Lin A, Bartolomé SP, Wood SJ, Ginsberg SD. Risk perception and risk-taking behaviour during adolescence: the influence of personality and gender. Ginsberg SD, editor. PLOS ONE. 2016;11(4):e0153842. doi:10.1371/journal.pone.0153842.
   PubMed Web of Science ®Google Scholar
• Lal A, Kolakowsky-Hayner SA, Ghajar J, Balamane M. The effect of physical exercise after a concussion a systematic review and meta-analysis. Am J Sports Med. 2018 Mar 1;46(3):743–52. doi:10.1177/0363546517706137.
   Web of Science ®Google Scholar
• Kontos AP, Collins MW, Holland CL, Reeves VL, Edelman K, Benso S, Schneider W, Okonkwo D. Preliminary evidence for improvement in symptoms, cognitive, vestibular, and oculomotor outcomes following targeted intervention with chronic mTBI patients. Mil Med. 2018;183(suppl_1):333–38. doi:10.1093/milmed/usx172.
   PubMedGoogle Scholar
• Brown L, Camarinos J. The role of physical therapy in concussion rehabilitation. Semin Pediatr Neurol. [2019 Jul 1];30:68–78. doi:10.1016/j.spen.2019.03.011.
   Web of Science ®Google Scholar