None listed
Conditions
Brief summary
People returning to sports after a mild traumatic brain injury (mTBI, also known as a concussion) carry a two times greater risk of a subsequent injury than those without a history of mTBI. This indicates that for some, there is ongoing impairment associated with their mTBI that is responsible for this increased risk, and current return to play (RTP) testing is not sufficient to identify these impairments. Impairments associated with dysfunction of the sensorimotor systems (including balance, vision) have been hypothesised to contribute to this increased risk. The proposed study is part of a series of studies that aim to develop a RTP testing protocol that is more sensitive to the ongoing effects of mTBI. This protocol includes the use of pre- and post- exertion measures because these have been shown to add value to the assessment of concussion in other domains, such as cognition, and incorporates sensorimotor measures. The study hypotheses are a) that the study protocol, and the exertion protocol, will be acceptable and safe for participants and b) that the included measures will have acceptable reliability. Exploratory analysis of the results will allow the required sample size of future studies to be determined.
Interventions
Participants will be randomised to either the physical exertion exposure at their first session, or rest, The physical exertion exposure will be based on the Gapski-Goodman Test (GGT) (Marshall et al., 2019). This involves an initial ramped intensity 8 minute warm up on an exercycle, followed by 2 x 2 minute bursts of high-intensity intervals of maximum effort on for 20 seconds, off for 20 seconds separated by 1 minute of active rest (minimal resistance). Following the bike portion, participants
Participants will be randomised to either the physical exertion exposure at their first session, or rest, The physical exertion exposure will be based on the Gapski-Goodman Test (GGT) (Marshall et al., 2019). This involves an initial ramped intensity 8 minute warm up on an exercycle, followed by 2 x 2 minute bursts of high-intensity intervals of maximum effort on for 20 seconds, off for 20 seconds separated by 1 minute of active rest (minimal resistance). Following the bike portion, participants will complete 4 plyometrics stations where they do 2 rounds of 1 minute of an exercise at maximum effort, separated by 30 seconds of rest. The exercises include 40cm box jumps, burpees, jump and turn, and 30cm hurdle step-overs. Participants will be verbally encouraged during plyometrics stages and high intensity exercycle intervals to give their maximum effort. Intensity will be monitored through the use of a heart rate monitor, and Borg Rate of Perceived Exertion (RPE), sampled at the conclusion of the bike portion and plyometrics portion. This will be completed in a rehabilitation gym setting using standard sized equipment and will be supervised by a registered physiotherapist with 15 years experience, assisted by a research assistant. There will be a maximum of two participants per session. They will return to complete the alternative exposure a minimum of three and a maximum of 10 days later.
Sponsors
Auckland University of Technology
Study design
Allocation
Randomised controlled trial
Intervention model
Crossover
Primary purpose
Educational / counselling / training
Masking
Blinded (masking used) (Investigator)
Eligibility
Sex/Gender
All
Age
18 Years to 40 Years
Healthy volunteers
Yes
Inclusion criteria
Group 1: Physically active healthy participants Inclusion criteria: i: 18-40 years old ii: currently participating in organised team sport and/or self-reporting that they participate in moderate and/or vigorous activity for more than 150 minutes per week (as defined in the World Health Organisation (WHO) guidelines). Group 2: Sports-related mTBI participants who are close to returning to sport Inclusion criteria: i: 18-40 years old ii: currently recovering from a diagnosis of SR-mTBI (sports-related mild traumatic brain injury) within the last six months, and are intending to return to sports ii: prior to injury, participating in organised team sport and/or self-reporting that they participate in moderate and/or vigorous activity for more than 150 minutes per week (as defined in WHO guidelines).
Exclusion criteria
Group 1: Physically active healthy participants Exclusion criteria: i: a self-reported history of mTBI in the previous 12 months or complaining of residual symptoms from a previous mTBI at any point. ii: self-reported musculoskeletal or medical conditions that limit balance, the ability to participate in exercise and/or performance of the outcome measures (including diagnosed peripheral vestibular conditions such as BPPV, and/or oculomotor or visual problems that are not mitigated with wearing corrective lenses). iii: self-reported acute illness; or a positive response to any of the COVID-19 screening questions indicating risk of potential infection. Group 2: Sports-related mTBI participants who are close to returning to sport Exclusion criteria: i: a diagnosis of moderate/severe TBI ii: self-reported musculoskeletal or medical conditions that limit balance, the ability to participate in exercise and/or performance of the outcome measures (including diagnosed peripheral vestibular conditions such as BPPV, and/or oculomotor or visual problems prior to the mTBI that are not mitigated with wearing corrective lenses). iii: self-reported acute illness; or a positive response to any of the COVID-19 screening questions indicating risk of potential infection. iiii: have already returned to sport from their most recent mTBI
Outcome results
None listed