1. Exploring Exercise Intolerance in mild TBI patients with Persistent Post-Concussion Symptoms: A Cross-Sectional Study.
- Author
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Valaas, Lars-Johan, Soberg, Helene L., Rasmussen, Mari S., Steenstrup, Sophie E., and Kleffelgård, Ingerid
- Subjects
RISK assessment ,PATIENTS ,EMERGENCY medical services ,SEVERITY of illness index ,FUNCTIONAL status ,CONFERENCES & conventions ,POSTCONCUSSION syndrome ,EXERCISE tolerance ,BRAIN injuries ,EXERCISE tests ,SOCIODEMOGRAPHIC factors ,DISEASE risk factors ,DISEASE complications ,ADULTS - Abstract
Introduction: Persistent post-concussion symptoms (PPCS) are common after mild traumatic brain injury (mTBI). There is a need to explore contributing factors to exacerbation of symptoms during physical activity, exercise intol- erance, in adult population with PPCS to provide effective rehabilitation Objective: Explore differences in demographic, injury-related, psychological, and physical functioning factors in patients with and without exercise intolerance tested on the Buffalo Concussion Treadmill Test (BCTT). Explore if these factors are associated with PPCS-burden in patients with exercise intolerance. Study design: Cross-sectional study of the baseline population in a randomized controlled trial: ClinicalTrials. gov:NCT05086419 Methods: Study population: 103 patients (57% female, mean age 37 years, SD:11) with mTBI and self-reported exercise intolerance recruited from the TBI outpatient clinic, Oslo University Hospital. Type of assessments: Exercise intolerance measured by BCTT (% of HRmax). Dependent variable: Rivermead Post- concussion Symptoms Questionnaire (RPQ). Independent variables: age, sex, days since injury, exercise intolerance, depression (PHQ-9), anxiety (GAD-7), fatigue (FSS), physical activity level (IPAQ). Results: Among the 103 patients, 81 (79%) tested exercise intolerant on the BCTT. The exercise intolerant group was younger (35.8 years, sd:10.6 vs. 41.4, sd:10.2, p=.029), had more co-morbidities (proportion: 69% vs 50%, p=0.09) and had shorter time since injury (days: 212 sd:113 vs. 288 sd:123, p=.013). All test parameters for the BCTT were significantly poorer for the exercise intolerant group. Headache (59%) and dizziness (36%) were the most frequently reported symptoms during BCTT. A multiple regression analysis with backward selection showed that female sex (b=3.49), days-since-injury (b=0.015), GAD-7 (b=0.58) and PHQ-9 (b=1.04) were significantly associated (p<.05) with higher PPCS-burden on the RPQ (adjR2= .46, p<.001), whereas exercise intolerance was not. Conclusions: Exercise intolerance was confirmed with BCTT for the majority of mTBI patients with self-reported exercise intolerance. Anxiety and depression was the strongest factors explaining PPCS-burden in patients with exercise intolerance after mTBI. [ABSTRACT FROM AUTHOR]
- Published
- 2024