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Identifying Trends of Dysautonomia Signs and Symptoms Associated with Protracted Concussion Recovery during the Buffalo Concussion Treadmill Test: A Retrospective Study

Published online by Cambridge University Press:  25 March 2022

Lauren Ziaks Open the ORCID record for Lauren Ziaks [Opens in a new window] ,
Jenna Tucker Open the ORCID record for Jenna Tucker [Opens in a new window] ,
Thomas Koc Jr ,
Alexa Schaefer  and
Kristina Hanson
Lauren Ziaks*
Affiliation:
Intermountain Rehabilitation Services, Park City Hospital, Park City, UT, USA
Jenna Tucker
Affiliation:
School of Physical Therapy, Kean University, Union, NJ, USA
Thomas Koc Jr
Affiliation:
School of Physical Therapy, Kean University, Union, NJ, USA
Alexa Schaefer
Affiliation:
School of Physical Therapy, Kean University, Union, NJ, USA
Kristina Hanson
Affiliation:
Intermountain Rehabilitation Services, Park City Hospital, Park City, UT, USA
*
*Corresponding author. Email: Lauren.Ziaks@imail.org
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Abstract

Objective:

To identify trends of provoked dysautonomia signs and symptoms during the Buffalo Concussion Treadmill Test (BCTT).

Subjects:

This is a retrospective cohort study of 101 patient charts post-concussion who were screened for suspected dysautonomia.

Methods:

Patients with suspected dysautonomia were assessed for exercise intolerance using a BCTT. Symptoms and rate of perceived exertion were recorded on a standardized form. Digital pulse oximetry was used to collect heart rate (HR) and oxygen saturation. Descriptive analyses were conducted on BCTT results.

Results:

Of 101 patient charts, 57 were excluded from analysis, including four patients who completed the BCTT by asymptomatically reaching the target HR zone for their estimated HR max. The remaining 44 patients demonstrated: 35 (79.5%) poor HR stabilization defined as a drop or plateau in HR during exercise, 28 (63.8%) exacerbated concussion symptoms, 13 (29.5%) autonomic nervous system response such as hot flushed sensation, 12 (27.3%) rebound symptoms during recovery phases, and 8 (18.2%) desaturation of 90% or below. The mean delta (80% expected HR max – 80% achieved HR max) on the initial test was 80.66 (± 23.08) beats per minute.

Conclusions:

This study is the first to identify trends of signs and symptoms during the BCTT in an expanded population with suspected dysautonomia after concussion. Future studies are indicated to validate these findings and contribute to development of modified termination criteria for the BCTT in individuals with suspected dysautonomia associated with protracted concussion recovery.

Keywords

Concussiondysautonomiaexercise intoleranceevaluation
Type
Articles
Information
Brain Impairment , First View , pp. 1 - 10
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of Australasian Society for the Study of Brain Impairment

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