The impact of fitness level on self-report of concussion symptoms

Abstract

BackgroundThe diagnosis and management of concussion in sport rely heavily on self-report of symptoms by the athlete. However, many symptoms commonly reported after a concussion (headache, nausea, fatigue, etc.) may be infl uenced by other factors. Fatigue is a frequent complaint, but may actually be a function of level of physical fi tness. Objective To evaluate the role of physical fi tness on self-report of concussion symptoms in collegiate athletes and students, during baseline testing. Design Prospective repeated measures. Participants 125 subjects were recruited, including 95 collegiate athletes and 30 undergraduate students (83 males and 42 females). Athletes were screened for medical and psychological conditions. No athlete had a recent history of concussion. Intervention Subjects completed the Standardised Concussion Assessment Tool (SCAT1) at three time periods: prior to a Leger (Beep) test, within 10 min of test completion, and within 24 h. The Leger test has established validity and reliability to estimate an athlete's V02 maximum and overall fi tness levels. Main outcome measures Estimated V02 max (Leger test) and symptom scores on the SCAT1. Results Subjects were grouped into three levels of fi tness according to criteria established by the American College of Sports Medicine (2010). A 3×3 repeated-measures ANOVA was not signifi cant for the overall model but showed a signifi cant interaction between time and fi tness level (F (2, 121)=3.50, p=0.02). Post-hoc analysis revealed signifi cant differences in report of symptoms among the three fi tness groups at baseline and immediately post-activity, but not at 24 h. Conclusion Results provide evidence of a moderating effect of fi tness level on report of concussion symptoms at baseline, even in healthy adults. Specifi cally, exercise can induce symptom reporting, and may a function of an athlete's level of conditioning. Sport medicine professionals making decisions following concussion need to consider an athlete's level of fi tness when evaluating post-concussion symptoms.