Due to differences in modalities , time course , study design and outcomes , it is not possible to define a single ‘ physiological time window ’ for SRC recovery .
Multiple studies suggest physiological dysfunction may outlast current clinical measures of recovery , supporting a buffer zone of gradually increasing activity before full contact risk .
Aim or objective The aim of this study is to consoli date studies of physiological measures following sport-related concussion ( SRC ) to determine if a time course of postinjury altered neurobiology can be outlined .
This biological time course was considered with respect to clinical ly relevant outcomes such as vulnerability to repeat injury and safe timing of return to physical contact risk .
Reliability of a Graded Exercise Test for Assessing Recovery From Concussion
Objective : To evaluate a grade d treadmill test for retest reliability ( RTR ) and interrater reliability ( IRR ) in the evaluation of the physiologic effects of symptom exacerbation from concussion . Design : Prospect i ve case series ( RTR ) and blinded rater assessment of 10 actors portraying patients with and without symptom exacerbation ( IRR ) . Setting : University Sports Medicine Concussion Clinic . Participants : For RTR , 21 refractory concussed patients ( 11 athletes and 10 nonathletes ) and 10 healthy subjects ; for IRR , 32 raters representing a variety of health care disciplines . Intervention : For RTR , a Balke protocol treadmill test to symptom exacerbation before and after 2 to 3 weeks . For IRR , video recordings of actors during the treadmill test viewed by raters blinded to condition . Main Outcome Measures : For RTR , agreement of the tests for maximal heart rate ( HR ) , systolic blood pressure , diastolic blood pressure , and rating of perceived exertion . For IRR , presence or absence of symptom exacerbation and the symptom exacerbation HR . Results : Raters achieved a sensitivity of 99 % for identifying actors with symptom exacerbation and a specificity of 89 % for ruling out concussion symptoms and agreed on 304 of 320 observations ( accuracy of 95 % ) . The intraclass correlation coefficient for the symptom exacerbation HR was large at 0.90 ( 95 % confidence interval , 0.78 - 0.98 ) . The treadmill test had good RTR for maximum HR ( intraclass correlation coefficient , 0.79 ) but not for systolic blood pressure , diastolic blood pressure , or rating of perceived exertion . Conclusions : The Balke exercise treadmill protocol has very good IRR and sufficient RTR for identifying patients with symptom exacerbation from concussion
Due to differences in modalities , time course , study design and outcomes , it is not possible to define a single ‘ physiological time window ’ for SRC recovery .
Multiple studies suggest physiological dysfunction may outlast current clinical measures of recovery , supporting a buffer zone of gradually increasing activity before full contact risk .
Aim or objective The aim of this study is to consoli date studies of physiological measures following sport-related concussion ( SRC ) to determine if a time course of postinjury altered neurobiology can be outlined .
This biological time course was considered with respect to clinical ly relevant outcomes such as vulnerability to repeat injury and safe timing of return to physical contact risk .