What is sports-related concussion?<\/b><\/p>\n
\u201cSports-related concussion (SRC) is a traumatic brain injury defined as a complex pathophysiological process affecting the brain, induced by biomechanical forces with several common features that help define its nature\u201d (1).<\/span><\/p>\n The Buffalo Concussion Treadmill Test (BCTT)<\/b><\/p>\n The BCTT (<\/span>2)<\/span> establishes appropriate exercise levels to avoid triggering symptoms post SRC, in order to create tailored programmes that aid Return To Play (RTP). Athletes identify any new or worsening symptoms of concussion, with each assigned a value of 1 point on the Visual Analogue Scale (VAS). The athlete\u2019s rate of perceived exhaustion (RPE) is recorded on a scale of 6 (no exertion) to 20 (unachievable maximum). The test is conducted on a treadmill using a consistent pace with the elevation increased one level every minute to increase intensity. Once the treadmill reaches maximum incline (15\u00b0), speed is increased by 0.4mph each minute in lieu. Measurements of heart rate (HR), VAS and RPE are taken every minute. The test is terminated when VAS increases by 3, with the HR at this point being the heart rate threshold (HRt). The test derives an athlete specific safe level of exercise at 90% of HRt.<\/span><\/p>\n Are there benefits to using the BCTT?<\/b><\/p>\n Leddy et al suggest that RTP is quicker from SRC in adolescents when sub-threshold aerobic exercise is started within 10 days of the injury compared to the conventional rest period (3).<\/span>\u00a0<\/span>This was supported by an enhanced RCT, employing a larger sample with more diverse injury seriousness (<\/span>4).<\/span> Athletes assigned to a sub-threshold aerobic group were more likely to recover within 4 weeks of injury compared to a stretching group. Further, BCTT is a reliable indicator of those likely to suffer a prolonged recovery with post-concussive symptoms: HRt<135bpm (5)<\/span> and\/or difference between resting HR and HRt <50bpm (6)<\/span>. Sub-threshold aerobic exercise treatment within 10 days of injury significantly reduces the incidence of delayed recovery in adolescent athletes; this is important as persistent post-concussive symptoms has been linked to a reduced quality of life (4).<\/span><\/p>\n In summary, application of sub-threshold aerobic exercise programmes for adolescents, calculated by the BCTT, will allow for early active management of SRC. This allows for an evidence-based method for quicker RTP and discussion for change to the current concussion guidelines.<\/span><\/p>\n References<\/b><\/p>\n Authors<\/b><\/p>\n![\"\"](\"https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/04\/Infographic-Does-Early-Exercise-in-Adolescents-Predict-Recovery-from-Sports-Related-Concussion-212x300.jpg\")
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