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- W2901293313 abstract "To determine whether graded exercise testing can predict recovery trajectory of concussion in children and adolescents.Prospective study.Children's Hospital, Westmead, Australia.One hundred thirty-nine children aged 12 to 16 years at 5 to 7 days after an acute concussive injury.Graded exercise testing on a treadmill at the subacute phase to assess symptom provocation and determine clinical recovery indicating readiness to commence a return to activity (RTA) protocol. Exercise time to symptom exacerbation and clinical recovery were measured.Standard concussion assessment and clinical testing (neurocognitive, vestibular/ocular, and balance) were conducted to determine major clinical drivers/indicators.Participants (mean age 12.4 ± 2.8 years, 73% male) had a confirmed sport-related concussion. The main clinical drivers identified on exercise testing were headache, balance, and vestibular dysfunction. Participants fell into 1 of 2 groups, exercise-tolerant (54%) and exercise-intolerant (46%). Exercise-tolerant patients showed mild clinical indicators, no symptom exacerbation during 10.3 ± 3.3 minutes of exercise, were safely transitioned to a RTA protocol, and recovered within 10 days. Exercise-intolerant patients had high clinical indicators, significant symptom exacerbation at 4.2 ± 1.6 minutes of exercise, and prolonged recovery of 45.6 days. No adverse effects from exercise were reported in either group. Combined use of provocative exercise and clinical testing was 93% predictive of outcome.Exercise testing during the subacute phase after a concussion can predict longer recovery. Exercise testing can identify a unique window where patients can be safely transitioned to activity, enabling clinicians to better inform patients and families, allocate resources and streamline care." @default.
- W2901293313 created "2018-11-29" @default.
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- W2901293313 date "2018-11-14" @default.
- W2901293313 modified "2023-10-13" @default.
- W2901293313 title "Graded Exercise Testing Predicts Recovery Trajectory of Concussion in Children and Adolescents" @default.
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- W2901293313 doi "https://doi.org/10.1097/jsm.0000000000000683" @default.
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