Key result
Concussion in adolescents impaired the heart rate response to brief isometric handgrip exercise compared to healthy controls (6.4 vs 13 beats/min; P<0.005).
Why the study?
Does concussion in adolescents impair the heart rate response to brief handgrip exercise?
Case-Control (n=35)
Does concussion in adolescents impair the heart rate response to brief handgrip exercise?
Adolescents with concussion demonstrate an impaired ability to elevate heart rate at the onset of exercise, suggesting neural cardiac dysregulation and reduced ability to withdraw cardiovagal control.
Impaired heart rate response after adolescent concussion may indicate autonomic dysregulation; hypothesis-generating for exercise tolerance and recovery.
OBJECTIVE: Test the hypotheses that (1) concussion in adolescents impairs autonomic neural control of heart rate (HR), and (2) HR reactivity improves with symptom resolution. DESIGN: Observational, case-control. PARTICIPANTS: Nineteen concussed adolescents (8 female adolescents; age 15 ± 2 years) and 16 healthy controls (6 female adolescents, age 15 ± 2 years). INTERVENTION: All participants performed an isometric handgrip (IHG) at 30% maximum voluntary contraction lasting 30 seconds. Heart rate (electrocardiogram) and hemodynamic responses (photoplethysmographic Finometer) were recorded from 30 seconds of baseline and the last 10 seconds of handgrip. MAIN OUTCOME MEASURES: The HR response (ΔHR) at the onset of moderate-intensity IHG using a mixed 1-way analysis of variance. RESULTS: A group × time interaction (P < 0.005) indicated that handgrip evoked a greater ΔHR among control participants (13 ± 10 beats/min) compared with concussed (6.4 ± 6.3 beats/min; group P = 0.63; time P < 0.001; d = 0.77). CONCLUSION: These preliminary results suggest that a concussion impairs the ability to elevate HR at the exercise onset and, given the nature of the task, this could be interpreted to reflect reduced ability to withdraw cardiovagal control. Therefore, the data support the hypothesis of neural cardiac dysregulation in adolescents diagnosed with concussion. CLINICAL RELEVANCE: The IHG test could aid concussion diagnosis and support return-to-play decisions.
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Woehrle et al. (2018) conducted a case-control in Concussion (n=35). Concussion vs. Healthy controls was evaluated on Heart rate response (ΔHR) at the onset of moderate-intensity isometric handgrip (d = 0.77, p=<0.005). Concussion in adolescents impaired the heart rate response to brief isometric handgrip exercise compared to healthy controls (6.4 vs 13 beats/min; P<0.005).
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