Use biofeedback measures to manage a patient's long term recovery from concussion.

Sports-related mild traumatic brain injury (MTBI) is estimated to affect 3.8 million people in the United States. Identifying quantitative measures of recovery has become a point of interest in treatment. Heart Rate Variability (HRV), the average fluctuation in the interval between heartbeats, shows promise as a noninvasive biomarker.

Case report following cardiovascular recovery of a 15 year old cross country runner 4 months post-injury. Average heart rate and maximum heart rate per training session were collected from the patient's smart device.

A 15-year-old Caucasian male cross-country runner hit the back of his head during a soccer game suffering an MTBI. The patient rested from the activity for 1 week then returned to training. Two months after the injury the patient complained of persistent shortness of breath, fatigue, and increased heart rate while running. According to the patient, his average BPM while running prior to the injury was in the 160s. The patient's smart device post-concussion reports a spike into the 180s. 3 months post-concussion the patient was instructed to keep his heart rate below 170 during training. In the following month, the patient's condition improved gradually with a return to baseline activity.

HRV is a promising point of investigation for the management of post-concussive symptoms. Further research is necessary to elucidate the long term effects of concussion on heart rate variability.