Robert F Graham1, Cody R van Rassel1, Joel S Burma1,2, Trevor D Rutschmann1, Lauren N Miutz1, Bonnie Sutter3, Kathryn J Schneider1,3,4,2,5. 1. 1Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada. 2. 4 Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada. 3. 2University of Calgary Sport Medicine Centre, Calgary, Alberta, Canada. 4. 3 Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada. 5. 5 Evidence Sport and Spinal Therapy, Calgary, Alberta, Canada.
Abstract
CONTEXT: Following concussion, a multi-faceted assessment is recommended, including tests of physical exertion. The current gold standard for exercise testing following concussion is the Buffalo Concussion Treadmill Test (BCTT); however, there is a lack of validated tests that utilize alternative exercise modalities. OBJECTIVE: To assess the feasibility and concurrent validity of a novel cycling test of exertion compared to the BCTT. DESIGN: Crossover Study Setting: University Sport-Medicine Clinic Patients: Twenty adults (aged 18-60 years) diagnosed with a Sport-Related Concussion Intervention: Participants completed the BCTT and a cycling test of exertion in a random order, approximately 48 hours apart. MAIN OUTCOME MEASURES: The primary outcome of interest was maximum heart rate [HRmax; beats per minute (bpm)]. Secondary outcomes of interest included whether the participant reached volitional fatigue (yes/no), symptom responsible for test cessation (Post Concussion Symptom Scale), and Symptom Severity on a Visual Scale (/10). RESULTS: Of the 20 participants, 19 (10 male, 9 female) completed both tests. One participant did not return for the second test and was excluded from the analysis. No adverse events were reported. The median HRmax for the BCTT [171 bpm; (IQR: 139-184bpm)] was not significantly different than the median HRmax for the Cycle [173 bpm; (IQR: 160-182)] (z=-0.63, p=0.53). For both tests, the three most frequently reported symptoms responsible for test cessation were Headache, Dizziness, and Pressure in the head. Of interest, the majority of participants (64%) reported a different symptom responsible for test cessation on each test. CONCLUSION: The novel cycling test of exertion achieved similar HRmax and test duration and may be a suitable alternative to the BCTT. Future research to understand the physiological reason for the heterogeneity in symptoms responsible for test cessation is warranted.
CONTEXT: Following concussion, a multi-faceted assessment is recommended, including tests of physical exertion. The current gold standard for exercise testing following concussion is the Buffalo Concussion Treadmill Test (BCTT); however, there is a lack of validated tests that utilize alternative exercise modalities. OBJECTIVE: To assess the feasibility and concurrent validity of a novel cycling test of exertion compared to the BCTT. DESIGN: Crossover Study Setting: University Sport-Medicine Clinic Patients: Twenty adults (aged 18-60 years) diagnosed with a Sport-Related Concussion Intervention: Participants completed the BCTT and a cycling test of exertion in a random order, approximately 48 hours apart. MAIN OUTCOME MEASURES: The primary outcome of interest was maximum heart rate [HRmax; beats per minute (bpm)]. Secondary outcomes of interest included whether the participant reached volitional fatigue (yes/no), symptom responsible for test cessation (Post Concussion Symptom Scale), and Symptom Severity on a Visual Scale (/10). RESULTS: Of the 20 participants, 19 (10 male, 9 female) completed both tests. One participant did not return for the second test and was excluded from the analysis. No adverse events were reported. The median HRmax for the BCTT [171 bpm; (IQR: 139-184bpm)] was not significantly different than the median HRmax for the Cycle [173 bpm; (IQR: 160-182)] (z=-0.63, p=0.53). For both tests, the three most frequently reported symptoms responsible for test cessation were Headache, Dizziness, and Pressure in the head. Of interest, the majority of participants (64%) reported a different symptom responsible for test cessation on each test. CONCLUSION: The novel cycling test of exertion achieved similar HRmax and test duration and may be a suitable alternative to the BCTT. Future research to understand the physiological reason for the heterogeneity in symptoms responsible for test cessation is warranted.