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?

• Published in: Brain injury Vol. 38; no. 12; pp. 1 - 1014
• Main Authors: Glendon, K, Blenkinsop, G, Belli, A, Pain, M T G
• Format: Journal Article
• Language: English
• Published: England 14-10-2024
• Subjects: vestibular-ocular-motor screening; Sports-related concussion; academic ability; neurocognition; early aerobic exercise
• ISSN: 0269-9052; 1362-301X; 1362-301X
• DOI: 10.1080/02699052.2024.2367477

Early Exercise Intolerance (EEI) is associated with delayed recovery and longer time to Return To Play (RTP), but this has not been established.Participants; (
 = 52, male
 = 30) UK university-aged rugby-union student-athletes.
Student-athletes completed baseline screening (July-October 2021 and 2022). The test battery was repeated within 48 h, 4, 8 and 14 days after a Sports-Related Concussion (SRC) with the Buffalo Concussion Bike or Treadmill Test to set sub-symptom heart rate threshold. Student-athletes then completed a controlled early exercise protocol in-between reassessment (days 3, 5-7 and 9-13). Those with EEI were compared to those with early-exercise tolerance.
Post-Concussion Symptom Scale, Immediate Post-Concussion and Cognitive Test, Vestibular-Ocular Motor Screening Tool and the Revised Perceived Academic Impact Tool.
EEI was seen throughout the initial 14-days post-SRC (23.8%, 22.4%, 25.5%. 25.0%). EEI was associated with a slower reaction time within 48 h (-0.01 (-0.030-0.043) Vs 0.06 (0.033-0.24),
 = 0.004) and greater VOMS scores within 48 h; (0.00 (0.00-4.00) Vs 5.50 (2.75-9.00),
 = 0.016) and 4 days (0.00 (0.00-2.00) Vs 5.00 (0.00-6.00),
 = 0.044). RTP was 12.5 days longer in those with EEI at 14-days post-SRC.
EEI is prevalent following an SRC in university-aged student-athletes and was associated with delayed recovery and RTP.