Use of the Buffalo Concussion Treadmill Test in community adult patients with mild traumatic brain injury.
Andrew DeGroot, Daniel L Huber, John J Leddy and 4 others
PMID 38411367WHAT IT FOUND
Adults with mild traumatic brain injury often stopped a treadmill exercise test early, commonly because dizziness, imbalance, or headache worsened.
But healthy controls also stopped frequently, mostly for pain or exertion, so test time alone does not prove brain-injury exercise intolerance.
Key findings
01Only 13.9% of adults with mTBI completed the treadmill test at 1 week and 16.0% at 1 month, and 36.1% and 40.0% stopped because mTBI symptoms worsened.
02Uninjured controls commonly met discontinuation criteria, with 70% stopping, mostly for other symptoms such as pain or discomfort.
03Within the mTBI group, more severe mTBI-related symptoms at 1 week were associated with shorter treadmill test duration at 1 week and 1 month.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The sample was small, and the analyses were mainly descriptive, so the findings need replication in a larger cohort. The groups were not perfectly matched: controls were on average 7 years older, and the mTBI group was more often non-white and had 2 years less education. Some participants had concurrent peripheral injuries, which could cause pain and be mistaken for mTBI symptom worsening. Healthy controls met discontinuation criteria at a high rate, with 70% stopping, mostly for non-specific pain or discomfort, which reduces the specificity of test duration. Heart rate was recorded only every 2 minutes, which may have reduced precision of the end-of-test heart-rate comparison. The authors could not definitively attribute nonspecific symptoms to mTBI rather than other causes.
Declared interests
The supplied article text does not include a conflict-of-interest or funding declaration. The publication types list NIH extramural research support.
The easy way to misread this
Do not assume a shorter treadmill test means mTBI-related exercise intolerance. Healthy controls also stopped often, mostly for pain, discomfort, or exertion, so the reason for stopping matters more than the time alone.