Abstract

A multifaceted assessment to inform clinicians of an athletes’ readiness to return to play (RTP) following sport-related concussion (SRC) includes symptoms, and neurocognitive, vestibular, and ocular function. Athletes must also complete a progressive exertion protocol that systematically increases exercise intensity and sport-specificity. However, ambiguous exercise parameters and reliance on subjective symptom reports limit the current approach and there is a need for a brief, clinical assessment to better inform RTP decisions. A novel dynamic exertion test (EXiT) that incorporates ACSM exercise prescription recommendations to replicate physiological demands from a variety of sport types and provides objective criteria can address these limitations. A comparison of EXiT outcomes between athletes recently cleared to RTP (RTP-A) and matched healthy controls (CON) is warranted to determine the clinical feasibility and interpretation of EXiT. PURPOSE: Compare heart rate (HR), endorsed symptoms, rating of perceived exertion (RPE), and performance outcomes during the completion of a 1) aerobic treadmill protocol, and 2) 5 hand-timed agility tasks between RTP-A and CON groups completing EXiT. METHODS: Twenty-eight (F=9, 32.1%;) athletes (ht.: 172.3±10.5 cm; wt.: 68.7± 14.5 kg) completed the EXiT test at RTP evaluation and were age-, gender-, and sport-matched to healthy controls (ht.: 171.1±9.0 cm, wt.: 64.1±17.5 kg). Participants wore an Equivital Lifemonitor physiological monitoring system, reported symptoms and RPE, and were timed by independent raters during completion of Box drills, Zigzag, Pro-agility, and Arrow agility EXIT tasks. Independent samples t-tests were conducted to compare HR, symptoms, RPE, and EXIT agility task completion time between RTP-A and CON groups.RESULTS: RTP-A and CON groups had similar post-EXIT HR (176.7±22.5 vs. 184.7±12.4), symptoms (0.93±3.56 vs. 2.00±5.92), RPE (15.7±2.8 vs. 15.0±2.9), and agility task completion time across EXIT outcomes. (p>.05). CONCLUSIONS: EXiT clinical outcomes were similar to athletes recently cleared to RTP following SRC and matched healthy controls. The new EXiT provides a multidomain, ACSM exercise criteria-based evaluation to inform RTP clinical decision making.
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