A - 42 Differences in Exercise Tolerance and Autonomic Function Based on Concussion Clinical Profile

• Published in: Archives of clinical neuropsychology 2024-10, Vol.39 (7), p.1295-1295
• Main Authors: Burley, C, Zynda, A J, Kehinde, F, Trbovich, A, Holland, C, Womble, M, Collins, M W, Elbin, R J, Kontos, A P
• Format: Article
• Language: English
• ISSN: 1873-5843; 1873-5843
• DOI: 10.1093/arclin/acae052.42

Abstract Purpose This study examined differences in clinical profiles (e.g., post-traumatic migraine, vestibular, anxiety/mood, oculomotor, and cognitive) between exercise tolerance groups determined by the Buffalo Concussion Bike Test (BCBT). We hypothesized the exercise-intolerant group would be more likely to have anxiety and/or vestibular profiles. Method Patients (18–49 years; 8 days to 6 months from concussion) completed demographic and medical history, the Clinical Profile Screen, Brief Symptom Inventory-18, and BCBT. Participants were adjudicated into one or more clinical profiles and classified as exercise tolerant or intolerant. Independent-sample t-tests and chi-square tests were used to compare demographics, clinical profiles, reasons for stopping the BCBT, and ANS metrics. Results One hundred six participants (mean age = 27.9¬ ± 8.1, 62.3% female) were included in the study (71 exercise-intolerant; 35 exercise-tolerant). No demographic or medical history differences were noted between groups. The exercise-intolerant group had significantly lower odds of having an adjudicated headache profile (OR = 0.39, 95%CI = 0.16–0.93, p = 0.03) and significantly greater odds of having an adjudicated autonomic profile (OR = 2.28, 95%CI = 1.01–5.21, p = 0.04). A greater proportion of those with the vestibular profile stopped the BCBT due to symptom exacerbation than those without (90.5% vs. 9.5%, p = 0.04). Conclusions Adjudicated clinical profiles and ANS metrics were similar between exercise-tolerant and intolerant groups. Vestibular sensitivities have a considerable contribution to symptom provocation during the BCBT, as a significant proportion of participants with the vestibular profile discontinued the BCBT due to symptom exacerbation. These findings corroborate previous research and suggest that exercise intolerance is pervasive across all concussion clinical profiles and should be considered in all evaluations.