The Effect of Physical Exertional Testing on Postconcussion Symptom Scale Scores in Male and Female High School Students

Purpose: Symptom scores commonly measured following concussion were compared between male and female adolescents with (Hx+) and without (Hx−) a history of concussion, pre and post physical exertion testing. Methods: Eighty (males [n = 60; Hx+ = 19], female [n = 20; Hx+ = 5]) high school students (ages 15–17 y) completed the Buffalo Concussion Treadmill Test once and the modified shuttle run test twice. Symptom scores were collected using the 22-point Symptom Evaluation Scale on the Sport Concussion Assessment Tool (version 5) immediately pre and post physical exertion testing. Results: The symptoms most reported during preexertional testing were fatigue/low energy, feeling slowed down, and nervous/anxious, whereas feeling slowed down, fatigue/low energy, “pressure in head” (males only), and headache (females only) were most frequently reported during postexertion testing. Conclusion: An understanding of the common exertion-related symptoms at baseline in a laboratory or field-based setting in adolescents may be advantageous for clinicians as they manage individual recovery postconcussion. This is particularly important during an adolescent’s recovery and return to play when exertional testing may be implemented, especially since symptoms were reported pre and post exertional testing in both males and females regardless of concussion history.