Faculty Collaboration Database

Use of the Buffalo Concussion Treadmill Test in community adult patients with mild traumatic brain injury. PM R 2024 Aug;16(8):826-835

Date

02/27/2024

Pubmed ID

38411367

Pubmed Central ID

PMC11323219

DOI

10.1002/pmrj.13132

Scopus ID

2-s2.0-85186544012 (requires institutional sign-in at Scopus site)

Abstract

BACKGROUND: The Buffalo Concussion Treadmill Test (BCTT) is used to establish exercise tolerance for rehabilitation and identify injury subtypes for youth athletes after mild traumatic brain injury (mTBI). Its utility in adult community members is unknown.

OBJECTIVE: Primary: To describe how adults with and without mTBI tolerate the BCTT. Secondary: To explore relationships between baseline factors, mTBI-related symptoms, and BCTT duration.

DESIGN: Prospective, observational, longitudinal.

SETTING: Academic medical center.

PARTICIPANTS: Thirty-seven adults treated in a level 1 trauma center emergency department with mTBI;  24 uninjured controls (UC).

INTERVENTIONS: N/A.

MAIN MEASURES: Participants completed two visits 3 weeks apart (1 week and 1 month after mTBI) including a 15-minute BCTT, the Rivermead Post Concussion Symptoms Questionnaire (RPQ), and preinjury International Physical Activity Questionnaire. Analyses characterized BCTT response and associations between baseline factors, RPQ scores, and BCTT duration.

RESULTS: Persons with mTBI discontinued earlier than UC at 1-week postinjury using standard discontinuation criteria for exercise intolerance. The percentage of mTBI participants with signs of possible mTBI-related intolerance was 55.6% at 1 week (36.1% for mTBI-related symptom exacerbation, 19.4% for exertion/fatigue before reaching 85% of one's age-predicted maximum heart rate [HR]) and 48.0% at 1 month (40.0% mTBI-related symptom exacerbation, 8.0% exertion without reaching the target HR). Thirty percent of UCs completed the BCTT at both assessments. UCs met discontinuation criteria for increased nonspecific symptoms (eg, pain/general discomfort and increased Visual Analog Scale ratings; 39-61%) and physical exertion (9-26%). Shorter duration was associated with higher body mass index (r = -0.42 - -0.45), shorter height (r = 0.22-0.29), female gender (r = -0.26 - -0.27), and greater RPQ symptoms (r = -0.28 - -0.47).

CONCLUSION: The BCTT exacerbates mTBI-related symptoms in adult community members. Participant characteristics and noninjury factors influence performance. The findings imply the BCTT could be useful in clinical assessments of adults with mTBI. Interpretation should account for the unique characteristics of nonathletes.

Author List

DeGroot A, Huber DL, Leddy JJ, Raff H, McCrea MA, Johnson BD, Nelson LD

Authors

Michael McCrea PhD Professor in the Neurosurgery department at Medical College of Wisconsin
Lindsay D. Nelson PhD Professor in the Neurosurgery department at Medical College of Wisconsin
Hershel Raff PhD Professor in the Academic Affairs department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Brain Concussion
Exercise Test
Exercise Tolerance
Female
Humans
Longitudinal Studies
Male
Middle Aged
Prospective Studies
Young Adult