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1. Citation: Quatman-Yates, C., Bailes, A., Constand, S., Sroka, M. C., Nissen, K., Kurowski, B., & Hugentobler, J. (2018). Exertional tolerance assessments after mild traumatic brain injury: A systematic review. Archives of Physical Medicine and Rehabilitation, 99(5), 994-1010.
Keywords: Brain injuries, exercise, literature reviews, physiology
Abstract: Study reviewed the literature to identify and summarize strategies for evaluating responses to physical exertion after mild traumatic brain injury (mTBI) for clinical and research purposes. A literature search was conducted using PubMed and EBSCOhost. Two independent reviewers selected studies based on the following criteria: (1) inclusion of participants with mTBI/concussion, (2) use of a measurement of physiological or psychosomatic response to exertion, (3) a repeatable description of the exertion protocol was provided, (4) a sample of at least 10 participants with a mean age between 8 and 65 years, and (5) the article was in English. The search process yielded 2,685 articles; after the full-text review relative to the eligibility criteria, 14 studies were included. A quality assessment using a checklist was conducted for each study by 2 independent study team members and verified by a third team member. Data were extracted by one team member and verified by a second team member. A qualitative synthesis of the studies revealed that most protocols used a treadmill or cycle ergometer as the exercise modality. Protocol methods varied across studies including differences in initial intensity determination, progression parameters, and exertion duration. Common outcome measures were self-reported symptoms, heart rate, and blood pressure. The strongest evidence indicates that exertional assessments can provide important insight about mTBI recovery and should be administered using symptoms as a guide. Additional studies are needed to verify optimal modes and protocols for post-mTBI exertional assessments.
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Record Updated:2018-10-24

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