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Fifteen minutes of high intensity running can impair performance on concussion testing; Implications for on-field diagnosis in sport

Published:October 21, 2022DOI:https://doi.org/10.1016/j.jsams.2022.10.011

      Abstract

      Objectives

      To examine the effects of 15 min of high intensity treadmill running on concussion testing assessed by the King-Devick test.

      Design

      Prospective Cohort Study.

      Methods

      Participants self-selected to either a running or a control group. At baseline both groups were assessed using the King-Devick concussion test. The running group then completed 15-minutes of treadmill running at rating of perceived exertion of 7–9/10 while the control group sat quietly. Both groups repeated the King-Devick test following that 15-minute period.

      Results

      Participants (n = 84 men, 53 women) were divided in two groups; running or control. Both groups, on average, had significant improvement after 15 min (suggesting a learning effect). Comparisons between the baseline and re-assessment scores indicated impaired performance was more common following high intensity treadmill running (n = 23 participants, 34.3%) compared to the control group (n = 10 participants, 14.3%, p = 0.006, OR = 3.44 [95%CI 1.40–8.50]). Four participants in the running group worsened their score at reassessment by more than 3 s compared to no participants in the control group.

      Conclusions

      After 15 min of high intensity treadmill running, 1 in 3 participants scored a slower time at follow-up or committed a mistake compared to baseline. Implications for clinical practise include: the recommendation that baseline tests be conducted at rest and after high intensity exercise to provide accurate comparisons to assist in clinical decision making; and a cut-off of >3 s may be a clinically useful difference between resting baseline and re-assessment using the King-Devick test.

      Keywords

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      References

        • Giza C.C.
        • Kutcher J.S.
        An introduction to sports concussions.
        Continuum (Minneapolis, Minn). 2014; 20: 1545-1551
        • Shenton M.E.
        • Hamoda H.M.
        • Schneiderman J.S.
        • et al.
        A review of magnetic resonance imaging and diffusion tensor imaging findings in mild traumatic brain injury.
        Brain Imaging Behav. 2012; 6: 137-192
        • Committee on Sports-Related Concussions in Y
        • Board on Children Y
        • Families, Institute of M
        • et al.
        The national academies collection: reports funded by National Institutes of Health.
        in: Graham R. Rivara F.P. Ford M.A. Spicer C.M. Sports-related Concussions in Youth: Improving the Science, Changing the Culture. National Academies Press (US), Washington (DC)2014 (Copyright 2014 by the National Academy of Sciences. All rights reservEd.)
        • Covassin T.
        • Elbin 3rd, R.J.
        • Stiller-Ostrowski J.L.
        • et al.
        Immediate post-concussion assessment and cognitive testing (ImPACT) practices of sports medicine professionals.
        J Athl Train. 2009; 44: 639-644
        • Meares S.
        • Shores E.A.
        • Taylor A.J.
        • et al.
        Validation of the abbreviated Westmead post-traumatic amnesia scale: a brief measure to identify acute cognitive impairment in mild traumatic brain injury.
        Brain Inj. 2011; 25: 1198-1205
        • McCrory P.
        • Meeuwisse W.
        • Dvorak J.
        • et al.
        Consensus statement on concussion in sport-the 5th international conference on concussion in sport held in Berlin, October 2016.
        Br J Sports Med. 2017; : 1-10
        • McCrea M.
        Standardized mental status testing on the sideline after sport-related concussion.
        J Athl Train. 2001; 36: 274-279
        • Galetta K.M.
        • Brandes L.E.
        • Maki K.
        • et al.
        The King-Devick test and sports-related concussion: study of a rapid visual screening tool in a collegiate cohort.
        J Neurol Sci. 2011; 309: 34-39
        • Tjarks B.J.
        • Dorman J.C.
        • Valentine V.D.
        • et al.
        Comparison and utility of King-Devick and ImPACT(R) composite scores in adolescent concussion patients.
        J Neurol Sci. 2013; 334: 148-153
        • Galetta K.M.
        • Barrett J.
        • Allen M.
        • et al.
        The King-Devick test as a determinant of head trauma and concussion in boxers and MMA fighters.
        Neurology. 2011; 76: 1456-1462
        • Leong D.F.
        • Balcer L.J.
        • Galetta S.L.
        • et al.
        The King-Devick test as a concussion screening tool administered by sports parents.
        J Sports Med Phys Fitness. 2014; 54: 70-77
        • Smolyansky V.
        • Morettin C.E.
        • Hitzman S.A.
        • et al.
        Test-retest reliability of the King-Devick test in elite junior olympic athletes.
        Ovp J. 2016; 4
        • Galetta K.M.
        • Liu M.
        • Leong D.F.
        • et al.
        The King-Devick test of rapid number naming for concussion detection: meta-analysis and systematic review of the literature.
        Concussion. 2016; 1 (null)
        • Galetta K.M.
        • Morganroth J.
        • Moehringer N.
        • et al.
        Adding vision to concussion testing: a prospective study of sideline testing in youth and collegiate athletes.
        J Neuroophthalmol. 2015; 35: 235-241
        • King D.
        • Gissane C.
        • Hume P.A.
        • et al.
        The King-Devick test was useful in management of concussion in amateur rugby union and rugby league in New Zealand.
        J Neurol Sci. 2015; 351: 58-64
        • King D.
        • Brughelli M.
        • Hume P.
        • et al.
        Concussions in amateur rugby union identified with the use of a rapid visual screening tool.
        J Neurol Sci. 2013; 326: 59-63
        • King D.
        • Clark T.
        • Gissane C.
        Use of a rapid visual screening tool for the assessment of concussion in amateur rugby league: a pilot study.
        J Neurol Sci. 2012; 320: 16-21
        • Burk J.M.
        • Munkasy B.A.
        • Joyner A.B.
        • et al.
        Balance error scoring system performance changes after a competitive athletic season.
        Clin J Sport Med. 2013; 23: 312-317
        • McCrea M.
        • Kelly J.P.
        • Randolph C.
        • et al.
        Standardized assessment of concussion (SAC): on-site mental status evaluation of the athlete.
        J Head Trauma Rehabil. 1998; 13: 27-35
        • Eddy R.
        • Goetschius J.
        • Hertel J.
        • et al.
        Test–retest reliability and the effects of exercise on the King-Devick test.
        Clin J Sport Med. 2020; 30: 239-244
        • Galetta K.M.
        • Liu M.
        • Leong D.F.
        • et al.
        The King-Devick test of rapid number naming for concussion detection: meta-analysis and systematic review of the literature.
        Concussion. 2016; 1: Cnc8
        • Norton K.
        • Norton L.
        • Sadgrove D.
        Position statement on physical activity and exercise intensity terminology.
        J Sci Med Sport. 2010; 13: 496-502
        • Fox J.
        Effect displays in R for generalised linear models.
        2003. 2003; 8: 27
        • Alsalaheen B.
        • Stockdale K.
        • Pechumer D.
        • et al.
        Cumulative effects of concussion history on baseline computerized neurocognitive test scores: systematic review and meta-analysis.
        Sports Health. 2017; 9: 324-332
        • Black A.M.
        • Miutz L.N.
        • Eliason P.H.
        • et al.
        The association of history of concussion with baseline scores on the sport concussion assessment tool (SCAT5) in high school rugby players.
        Orthop J Sports Med. 2019; 72325967119S2325900006
        • Leong D.F.
        • Balcer L.J.
        • Galetta S.L.
        • et al.
        The King-Devick test for sideline concussion screening in collegiate football.
        J Optom. 2015; 8: 131-139
        • Weuve J.
        • Kang J.H.
        • Manson J.E.
        • et al.
        Physical activity, including walking, and cognitive function in older women.
        JAMA. 2004; 292: 1454-1461
        • Smoliga J.M.
        • Mohseni Z.S.
        • Berwager J.D.
        • et al.
        Common causes of dyspnoea in athletes: a practical approach for diagnosis and management.
        Breathe (Sheff). 2016; 12 (e22-37)
        • Abd-Elfattah H.M.
        • Abdelazeim F.H.
        • Elshennawy S.
        Physical and cognitive consequences of fatigue: a review.
        J Adv Res. 2015; 6: 351-358