Exercise-Induced Symptom Exacerbation and Adverse Events in Moderate-to-Severe Traumatic Brain Injury
Gallow, Sara BPhysio; McGinley, Jennifer PhD; Olver, John MD, FAFRM; McKenzie, Dean PhD; Williams, Gavin PhD
Objective
To determine the incidence of exercise-induced symptom exacerbation and adverse events from cardiorespiratory fitness (CRF) and high-level mobility (HLM) exertional testing in the early subacute phase (≤3 months post-injury) following moderate-to-severe traumatic brain injury (TBI).
Setting
Inpatient TBI subacute rehabilitation unit.
Participants
One hundred fifty adults and adolescents ≥15 years with moderate-to-severe TBI completed a total of 205 exertional tests (83 participants completed CRF only, 12 HLM only, and 55 both CRF and HLM).
Design
Prospective observational cohort study. Consecutive admissions were screened for recruitment between August 2017 and August 2021. Symptom ratings were recorded pre- and post-CRF and HLM exertional testing on the Sports Concussion Assessment Tool symptom scale. A summed symptom severity score (SCAT-SS) was calculated with a ≥10-point increase classified as symptom exacerbation and a ≥10-point reduction classified as symptom improvement.
Main measures
SCAT symptom scale.
Results
One participant experienced a ≥10-point increase in SCAT-SS (ie, symptom exacerbation) post-CRF testing (1/138 = 0.7%, 95% confidence interval [CI] = 0.01%-4.0%) and 1 post-HLM testing (1/67 = 1.5%, 95% CI = 0.04%-8.0%). Sixteen of 138 (11.6%, 95% CI = 6.8%-18.1%) CRF tests resulted in a ≥10-point decrease in SCAT-SS (ie, symptom improvement). Nine of 67 (13.4%, 95% CI = 6.3%-24.0%) HLM tests resulted in a ≥10-point decrease in SCAT-SS. Participants were more likely to experience symptom improvement than symptom exacerbation for both CRF and HLM exertion (P ≤ .05). One adverse event, a fall, occurred during an HLM testing session.
Conclusions
CRF and HLM exertional testing in the early subacute phase of recovery following moderate-to-severe TBI appears to be safe, with low rates of symptom exacerbation and adverse events identified.
Web | Journal of Head Trauma Rehabilitation | Paywall
Gallow, Sara BPhysio; McGinley, Jennifer PhD; Olver, John MD, FAFRM; McKenzie, Dean PhD; Williams, Gavin PhD
Objective
To determine the incidence of exercise-induced symptom exacerbation and adverse events from cardiorespiratory fitness (CRF) and high-level mobility (HLM) exertional testing in the early subacute phase (≤3 months post-injury) following moderate-to-severe traumatic brain injury (TBI).
Setting
Inpatient TBI subacute rehabilitation unit.
Participants
One hundred fifty adults and adolescents ≥15 years with moderate-to-severe TBI completed a total of 205 exertional tests (83 participants completed CRF only, 12 HLM only, and 55 both CRF and HLM).
Design
Prospective observational cohort study. Consecutive admissions were screened for recruitment between August 2017 and August 2021. Symptom ratings were recorded pre- and post-CRF and HLM exertional testing on the Sports Concussion Assessment Tool symptom scale. A summed symptom severity score (SCAT-SS) was calculated with a ≥10-point increase classified as symptom exacerbation and a ≥10-point reduction classified as symptom improvement.
Main measures
SCAT symptom scale.
Results
One participant experienced a ≥10-point increase in SCAT-SS (ie, symptom exacerbation) post-CRF testing (1/138 = 0.7%, 95% confidence interval [CI] = 0.01%-4.0%) and 1 post-HLM testing (1/67 = 1.5%, 95% CI = 0.04%-8.0%). Sixteen of 138 (11.6%, 95% CI = 6.8%-18.1%) CRF tests resulted in a ≥10-point decrease in SCAT-SS (ie, symptom improvement). Nine of 67 (13.4%, 95% CI = 6.3%-24.0%) HLM tests resulted in a ≥10-point decrease in SCAT-SS. Participants were more likely to experience symptom improvement than symptom exacerbation for both CRF and HLM exertion (P ≤ .05). One adverse event, a fall, occurred during an HLM testing session.
Conclusions
CRF and HLM exertional testing in the early subacute phase of recovery following moderate-to-severe TBI appears to be safe, with low rates of symptom exacerbation and adverse events identified.
Web | Journal of Head Trauma Rehabilitation | Paywall