Graded Aerobic Treadmill Testing in Adolescent Traumatic Brain Injury Patients

Cordingley, Dean M.; Girardin, Richard; Morissette, Marc; Reimer, Karen; Leiter, Jeff; Russell, Kelly; Ellis, Michael J.

doi:10.1017/cjn.2017.209

Cited by 8 publications

(3 citation statements)

References 51 publications

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“…The BCTT protocol was applied as has been previously described. 3,4,18 This test was conducted by the same exercise physiologist at both locations and applied uniformly across all age groups for those with persistent SR-mTBI symptoms 14 days after their initial consult.…”

Section: Buffalo Concussion Treadmill Test Protocolmentioning

confidence: 99%

Can the Buffalo Concussion Treadmill Test Be Used as a Prognostic Indicator for Patients With Sport-Related Mild Traumatic Brain Injury?

Kumar¹,

Kara²,

Werf

et al. 2023

Clinical Journal of Sport Medicine

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Objective: To establish whether time to exercise cessation using the Buffalo Concussion Treadmill Test (BCTT) protocol can be used as a prognostic indicator of recovery after sport-related mild traumatic brain injury (SR-mTBI). Design: Retrospective analysis of prospectively collected data. Setting: Specialist Concussion Clinic. Participants: Three hundred and twenty one patients presenting between 2017 and 2019 who underwent BCTT for SR-mTBI. Interventions: Participants who remained symptomatic at a 2-week follow-up appointment after SR-mTBI underwent BCTT to develop a progressive subsymptom threshold exercise program with fortnightly follow-up until clinical recovery. Main Outcome Measures: Clinical recovery was the primary outcome measure. Results: A total of 321 participants were eligible to participate in this study (mean age 22.94% and 46% female). The BCTT test duration was divided into 4-minute intervals and those who completed full 20 minutes. There was higher probability of clinical recovery in those who finished the entire 20-minute BCTT protocol compared with those who managed 17–<20 minutes (Hazard Ratio, HR 0.57), 13 to 16 minutes (HR 0.53), 9 to 12 minutes (HR 0.6), 5 to 8 minutes (HR 0.4), and 1 to 4 minutes (HR 0.7), respectively. Those seen earlier after injury (P = 0.009), male patients (P = 0.116), younger patients (P = 0.0003), and those with physiological or cervical dominant (P = 0.416) symptom clusters were more likely to achieve clinical recovery. Fifty percent of those who completed the full BCTT protocol achieved clinical recovery at day 19 post‐injury. Conclusions: The group completing full 20 minutes of BCTT achieved clinical recovery more quickly than those who did not complete full BCTT.

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Section: Buffalo Concussion Treadmill Test Protocolmentioning

confidence: 99%

Can the Buffalo Concussion Treadmill Test Be Used as a Prognostic Indicator for Patients With Sport-Related Mild Traumatic Brain Injury?

Kumar¹,

Kara²,

Werf

et al. 2023

Clinical Journal of Sport Medicine

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“…Buffalo Concussion Treadmill Protocol. We used a modified version of the BCTT previously implemented by Cordingley et al 21,22 and Morissette et al 23 It deviates slightly from the BCTT used by Leddy et al 10 with a more conservative belt speed increment (0.2 mph/min [0.32 km/ h/min] instead of 0.4 mph/min [0.64 km/h/min]) and a more conservative stopping criterion (a 2-point instead of 3-point increase in symptom severity based on a visual scale to define symptom-limited test cessation). This was done to maintain the safety of various participant populations and across multiple age groups.…”

Section: Exercise Protocolsmentioning

confidence: 99%

Concurrent Validity of a Stationary Cycling Test and the Buffalo Concussion Treadmill Test in Adults With Concussion

Graham

Rassel

Burma

et al. 2021

Journal of Athletic Training

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Context: Following concussion, a multi-faceted assessment is recommended, including tests of physical exertion. The current gold standard for exercise testing following concussion is the Buffalo Concussion Treadmill Test (BCTT); however, there is a lack of validated tests that utilize alternative exercise modalities. Objective: To assess the feasibility and concurrent validity of a novel cycling test of exertion compared to the BCTT. Design: Crossover Study Setting: University Sport-Medicine Clinic Patients: Twenty adults (aged 18–60 years) diagnosed with a Sport-Related Concussion Intervention: Participants completed the BCTT and a cycling test of exertion in a random order, approximately 48 hours apart. Main Outcome Measures: The primary outcome of interest was maximum heart rate [HRmax; beats per minute (bpm)]. Secondary outcomes of interest included whether the participant reached volitional fatigue (yes/no), symptom responsible for test cessation (Post Concussion Symptom Scale), and Symptom Severity on a Visual Scale (/10). Results: Of the 20 participants, 19 (10 male, 9 female) completed both tests. One participant did not return for the second test and was excluded from the analysis. No adverse events were reported. The median HRmax for the BCTT [171 bpm; (IQR: 139–184bpm)] was not significantly different than the median HRmax for the Cycle [173 bpm; (IQR: 160–182)] (z=–0.63, p=0.53). For both tests, the three most frequently reported symptoms responsible for test cessation were Headache, Dizziness, and Pressure in the head. Of interest, the majority of participants (64%) reported a different symptom responsible for test cessation on each test. Conclusion: The novel cycling test of exertion achieved similar HRmax and test duration and may be a suitable alternative to the BCTT. Future research to understand the physiological reason for the heterogeneity in symptoms responsible for test cessation is warranted.

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“…11 In those with acute concussion, PCS, PPCS and PPCD, exertional testing has emerged as a tool for identifying exercise intolerance or provoking more subtle symptoms that are not obvious at rest. 10,[12][13][14][15] Additionally, exertional testing provides objective information and reduces the reliance on subjective symptom reporting, which can be unreliable, 16 with symptoms underreported. 17 The Buffalo Concussion Treadmill Test (BCTT) is a progressive exertional test that has been developed to support assessment and management of this population.…”

Section: Introductionmentioning

confidence: 99%

Clinical application of the Buffalo Concussion Treadmill Test and the Buffalo Concussion Bike Test: A systematic review

Janssen

Pope

Rando

2022

Journal of Concussion

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Objective To identify and synthesise research evidence regarding psychometric properties and clinical utility of the Buffalo Concussion Treadmill Test (BCTT) and Buffalo Concussion Bike Test (BCBT) for use with patients with acute concussion, post-concussion syndrome (PCS) or physiological post-concussion disorder (PPCD). Data sources ProQuest (ProQuest Central), PEDro, Medline (Ovid), Emcare (Ovid), EBSCOhost (Health collection) and Google Scholar, searched September 8th-12th, 2020. Study selection Two authors independently selected studies that met eligibility criteria. Studies were selected if they were original research of any design, that investigated the properties of the testing protocols in either concussed or uninjured participants. Articles not published in English, that were not original research or that used significantly different testing protocols were excluded. The search yielded 250 articles, 11 of which were eligible and included in this review. Data extraction Included studies were critically appraised independently by two authors, using the Mixed Methods Appraisal Tool (MMAT). Data relating to study characteristics and key findings were extracted from the studies, documented in tables, and used to inform a critical narrative synthesis of findings. Data synthesis To provide recommendations relating to each aim of the review, a strength of evidence scoring system was used. Available evidence supported use of the BCTT, with strong evidence supporting the safety and construct validity of the test and moderate evidence supporting its prognostic value. There has been very limited research investigating use of the BCBT. Conclusion The findings support a recommendation for use of the BCTT in clinical settings for management of acute concussion, PCS and PPCD. There is limited evidence available for the BCBT. Additional studies are needed of both tests to further establish their clinical value.

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Graded Aerobic Treadmill Testing in Adolescent Traumatic Brain Injury Patients

Cited by 8 publications

References 51 publications

Can the Buffalo Concussion Treadmill Test Be Used as a Prognostic Indicator for Patients With Sport-Related Mild Traumatic Brain Injury?

Can the Buffalo Concussion Treadmill Test Be Used as a Prognostic Indicator for Patients With Sport-Related Mild Traumatic Brain Injury?

Concurrent Validity of a Stationary Cycling Test and the Buffalo Concussion Treadmill Test in Adults With Concussion

Clinical application of the Buffalo Concussion Treadmill Test and the Buffalo Concussion Bike Test: A systematic review

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