Abstract Details

Title Sex Differences in Heart Rate Recovery in Adolescents With Recent Concussion

Topic Neuro Trauma and Critical Care

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 3-010

Objective To examine sex differences in heart rate (HR) recovery following acute aerobic exercise in adolescents with recent concussion and its relation to performance on clinical concussion assessments.

Background

HR recovery provides insight into the capacity of the parasympathetic branch of the autonomic nervous system (ANS) to adapt to changing situational demands. ANS dysfunction commonly occurs following concussion and may contribute to symptom presentation. Females often have poorer concussion outcomes than males and differ in pre-injury ANS function; however, sex differences in HR recovery post-concussion have yet to be elucidated.

Design/Methods

We conducted a retrospective analysis of data from a pediatric specialty clinic. Participants completed the Buffalo Concussion Treadmill Test (BCTT) followed by a battery of clinical concussion assessments: the Vestibular Ocular Motor Screening tool (VOMS); Balance Error Scoring System (BESS); and the Cogstate neurocognitive assessment. HR, symptom severity, and perceived exertion (RPE) were recorded during exercise and for five minutes post-exercise.

Results Participants included 31 female and 41 male adolescents with recent concussion who completed the BCTT to 85% of their age-predicted maximal HR without symptom exacerbation. Male participants exercised for a longer duration than females (p=.003). There were no group differences in baseline HR or speed of HR recovery (p’s>.05), but females displayed a smaller percentage change from baseline HR when stopping exercise (p=.03). Females displayed slower reaction times and lower accuracy on a two-back working memory task, and higher odds of symptom provocation during horizontal vestibular ocular reflex (p’s<.05). Metrics of exercise recovery were not related to performance on clinical assessments (p’s>.05).

Conclusions In the exercise tolerant, our findings did not suggest HR recovery to be a primary mechanism underlying sex differences on clinical assessments of concussion for adolescents. Future research should examine HR recovery and additional parasympathetic metrics, such as heart rate variability, in an exercise intolerant and/or sedentary cohort.

Authors/Disclosures
Kiersten Mangold (Arnold School of Public Health) PRESENTER	Miss Mangold has nothing to disclose.
Jacob Kay, PhD (Prisma Health Children's Hospital)	Mr. Kay has nothing to disclose.
Raouf S. Gharbo, DO	Prof. Gharbo has nothing to disclose.
Jeff Holloway, MD	Dr. Holloway has nothing to disclose.
R. Davis Moore, PhD (University of South Carolina)	Dr. Moore has nothing to disclose.

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