AUTHOR=Haider Mohammad N. , Leddy John J. , Wilber Charles G. , Viera Kaitlin B. , Bezherano Itai , Wilkins Kimberly J. , Miecznikowski Jeffrey C. , Willer Barry S. 

TITLE=The Predictive Capacity of the Buffalo Concussion Treadmill Test After Sport-Related Concussion in Adolescents

JOURNAL=Frontiers in Neurology

VOLUME=10

YEAR=2019

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2019.00395

DOI=10.3389/fneur.2019.00395

ISSN=1664-2295

ABSTRACT=<p>The Buffalo Concussion Treadmill Test (BCTT) identifies the heart rate threshold (HRt) of exercise tolerance in concussed patients. A previous study found that an absolute HRt of &lt; 135 bpm was associated with prolonged recovery (&gt;30 days) from sport-related concussion (SRC). In this study, we assessed the relationship of ΔHR (difference between resting HR and HRt) and recovery from SRC. Using a retrospective cohort design, we compared acutely (&lt;10 days since injury) concussed adolescents who were prescribed either (1) relative rest (RG, <italic>n</italic> = 27, 15.2 ± 1 years, 33% female, median 17 days to recovery, ΔHR = 69.6 ± 28 bpm), (2) a placebo-stretching program (PG, <italic>n</italic> = 51, 15.4 ± 2 years, 49% female, median 17 days to recovery, ΔHR = 60.9 ± 22 bpm), or (3) sub-threshold aerobic exercise (AG, <italic>n</italic> = 52, 15.3 ± 2 years, 46% female, median 13 days to recovery, ΔHR = 62.4 ± 26 bpm). Linear regression showed that ΔHR significantly correlated with duration of clinical recovery for RG (<italic>p</italic> = 0.012, <italic>R</italic><sup>2</sup> = 0.228) and PG (<italic>p</italic> = 0.011, <italic>R</italic><sup>2</sup> = 0.126) but not for AG (<italic>p</italic> = 0.084, <italic>R</italic><sup>2</sup> = 0.059). ΔHR values were significantly lower in participants with prolonged recovery (&gt;30 days) in RG (<italic>p</italic> = 0.01) and PG (<italic>p</italic> = 0.04). A ΔHR of ≤50 bpm on the BCTT is 73% sensitive and 78% specific for predicting prolonged recovery in concussed adolescents who were prescribed the current standard of care (i.e., cognitive and physical rest).</p>