Heart Rate Variability of Recently Concussed Athletes at Rest and Exercise

Gall, Brent; Parkhouse, W. S.; Goodman, David

doi:10.1249/01.mss.0000135787.73757.4d

Cited by 146 publications

(207 citation statements)

References 21 publications

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“…Concussion affects the autonomic nervous system (ANS) 27,28 and the control of both cerebral blood flow (CBF) [29][30][31][32] and cardiac rhythm. 33,34 The primary ANS control center may be damaged in concussion, particularly if a rotational force was applied to the upper cervical spine, 35 as supported by results from a diffusion tensor imaging study 36 that showed changes to brainstem white matter neurons after concussion. The metabolic and physiological dysfunction typically but not always resolves within days to weeks after injury.…”

Section: The Physiology Of Concussionmentioning

confidence: 97%

“…43 Heart-rate variability has been used to quantify autonomic dysfunction across a broad spectrum of TBI severity, including concussion. 33,44,45 Autonomic dysfunction after TBI is believed to represent some degree of uncoupling between the brain autonomic centers and the cardiovascular system, 44 can be precipitated by different types of exercise in patients after concussion, 28,33 and improves as patients recover from severe TBI 46 or from concussion. 28 One group, for example, showed that concussed athletes who reported recent symptom resolution had abnormal HRV 33 and elevated heart rates (HRs) 34 during steady-state exercise (but not at rest) versus healthy controls, which is consistent with increased SNS activation during exercise after concussion.…”

Section: The Physiology Of Concussionmentioning

confidence: 99%

“…A program of subthreshold aerobic exercise restored their carbon dioxide sensitivity, ventilation, exercise CBF, and exercise tolerance to normal in association with symptom resolution. Others have identified abnormal autonomic regulation of BP 48 and HR 33,34 in patients with concussion.…”

Section: The Athlete With Prolonged Recoverymentioning

confidence: 99%

See 2 more Smart Citations

A Physiological Approach to Prolonged Recovery From Sport-Related Concussion

Leddy¹,

Baker²,

Haider

et al. 2017

Journal of Athletic Training

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Management of the athlete with postconcussion syndrome (PCS) is challenging because of the nonspecificity of PCS symptoms. Ongoing symptoms reflect prolonged concussion pathophysiology or conditions such as migraine headaches, depression or anxiety, chronic pain, cervical injury, visual dysfunction, vestibular dysfunction, or some combination of these. In this paper, we focus on the physiological signs of concussion to help narrow the differential diagnosis of PCS in athletes. The physiological effects of exercise on concussion are especially important for athletes. Some athletes with PCS have exercise intolerance that may result from altered control of cerebral blood flow. Systematic evaluation of exercise tolerance combined with a physical examination of the neurologic, visual, cervical, and vestibular systems can in many cases identify one or more treatable postconcussion disorders.

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Section: The Physiology Of Concussionmentioning

confidence: 97%

Section: The Physiology Of Concussionmentioning

confidence: 99%

See 1 more Smart Citation

A Physiological Approach to Prolonged Recovery From Sport-Related Concussion

Leddy¹,

Baker²,

Haider

et al. 2017

Journal of Athletic Training

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show abstract

“…Likewise, higher HRs have been reported in concussed athletes as a response to exercise, than in matched controls. 31,32 Increases in HR were not observed in the fRW condition, in which the pattern of exercise consisted of two 20 min daily sessions, In contrast to fRW, vRW was ad libitum mostly during the dark phase of PIDs 0-4 and PIDs 7-11. These increases in HR, observed in the FPI-vRW group, are more likely to be reflective of aerobic capacity than of exercise intensity.…”

mentioning

confidence: 89%

Temperature and Heart Rate Responses to Exercise following Mild Traumatic Brain Injury

Griesbach

Tio

Nair

et al. 2013

Journal of Neurotrauma

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We have previously reported that mild fluid percussion injury (FPI) is associated with a heightening of the hypothalamic-pituitary-adrenal axis response during the first post-injury weeks. This is the same time period when rehabilitative exercise has been strongly suggested to be ineffective. Here, we explored whether cardiac and temperature autonomic function may also be compromised during this early post-injury period. Following an FPI or sham injury, rats were exercised with forced (fRW) or voluntary (vRW) running wheels on post-injury days 0-4 and 7-11. Results indicated that overall activity levels were decreased and circadian rhythm was affected after FPI. Autonomic disruptions became evident when exercise was introduced, and these disruptions were dependent upon the characteristics of exercise. Elevations in heart rate (HR) and core body temperature (CBT) were observed as a response to vRW and fRW. FPI animals had more pronounced increases in HR as a result of vRW. Likewise, increases in HR were observed with fRW in all animals. A strong stress response has recently been associated with fRW exercise. FPI rats exposed to fRW were more responsive to experimental manipulations and had higher a CBT after the FRW session. The results suggest that subacute exercise, particularly if linked to a strong stress response, may be counterproductive. Here we show that cardiac and temperature autonomic function are compromised during the subacute period following a mild TBI.

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“…Only temporal series of more than 256 RR intervals were used for analysis 31 . The RR intervals were exported for analysis by HRV Analysis Software (Biosignal Analysis and Medical Imaging Group, University of Kuopio, Finland) 32,33 . With this program, HRV calculation was performed in the temporal and frequency domains.…”

Section: Monitoring the Cardiovascular Systemmentioning

confidence: 99%