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Objective <p>To compare autonomic nervous system (ANS) response using the Buffalo Concussion Bike Test (BCBT) between adult post-concussion patients with and without pre-existing and post-injury anxiety.</p> Design <p>Cross-sectional cohort study of participants from the Targeted, Multidomain (T-MD) Treatment for Concussion Randomized Controlled Trial.</p> Setting <p>Two concussion specialty clinics.</p> Participants <p>Ages 18–49&#xa0;years, 8&#xa0;days to 6&#xa0;months from injury, without a history of cardiovascular/neurological/vestibular disorders. 256 participants were eligible, 120 declined, 136 enrolled, and 30 were excluded.</p> Exposures <p>Participants completed the BCBT at a baseline study visit following initial clinical evaluation.</p> Main outcomes and measures <p>Number of BCBT stages completed and Visual Analogue Scale (VAS), heart rate (HR), blood pressure (BP), and Ratings of Perceived Exertion (RPE) pre- and post-BCBT.</p> Results <p>106 participants (age = 25.5 [12.5], 66 [62.3%] female) were included, 44 (41.5%) with pre-existing anxiety, 61 (57.6%) without pre-existing anxiety, 33 (31.1%) with post-injury anxiety, and 73 (68.9%) without post-injury anxiety. Eighteen (17.0%) were in both anxiety groups. Results supported a significant group x time interaction in participants with pre-existing anxiety for increased diastolic BP (F[1,97] = 5.03, <i>p</i> = 0.03) and VAS (F[1,99] = 5.05, <i>p</i> = 0.03) while controlling for covariates. Participants with pre-existing anxiety (median = 8[4]) and post-injury anxiety (median = 8[5]) completed fewer BCBT stages than those without pre-existing (median = 11[6], <i>p</i> &lt; 0.01) and post-injury (median = 10[6], <i>p</i> = 0.03) anxiety.</p> Conclusions <p>Adults with pre-existing and post-injury anxiety experienced altered physiological responses to exercise post-concussion and completed fewer stages of the BCBT. Anxiety should be considered by clinicians when interpreting findings from exercise intolerance tests such as the BCBT.</p> <p>Trial Registration: <a href="http://www.clinicaltrials.gov">www.clinicaltrials.gov</a>; identifier: NCT04549532; <a href="https://clinicaltrials.gov/study/NCT04549532">https://clinicaltrials.gov/study/NCT04549532</a></p>

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Role of anxiety in exercise intolerance and autonomic nervous system dysfunction post-concussion

  • 期刊论文

  • 发表日期：

    2025年4月28日

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  • Aaron J. Zynda,
  • Alicia M. Trbovich,
  • Faith Kehinde,
  • Christopher Burley,
  • Michael W. Collins,
  • David O. Okonkwo,
  • Anne Mucha,
  • Sarah Ostop,
  • Cyndi Holland,
  • Courtney Perry,
  • Melissa N. Womble,
  • Sabrina Jennings,
  • Sheri Fedor,
  • Christina Dollar,
  • Kori J. Durfee,
  • R. J. Elbin,
  • Anthony P. Kontos

摘要

Objective

To compare autonomic nervous system (ANS) response using the Buffalo Concussion Bike Test (BCBT) between adult post-concussion patients with and without pre-existing and post-injury anxiety.

Design

Cross-sectional cohort study of participants from the Targeted, Multidomain (T-MD) Treatment for Concussion Randomized Controlled Trial.

Setting

Two concussion specialty clinics.

Participants

Ages 18–49 years, 8 days to 6 months from injury, without a history of cardiovascular/neurological/vestibular disorders. 256 participants were eligible, 120 declined, 136 enrolled, and 30 were excluded.

Exposures

Participants completed the BCBT at a baseline study visit following initial clinical evaluation.

Main outcomes and measures

Number of BCBT stages completed and Visual Analogue Scale (VAS), heart rate (HR), blood pressure (BP), and Ratings of Perceived Exertion (RPE) pre- and post-BCBT.

Results

106 participants (age = 25.5 [12.5], 66 [62.3%] female) were included, 44 (41.5%) with pre-existing anxiety, 61 (57.6%) without pre-existing anxiety, 33 (31.1%) with post-injury anxiety, and 73 (68.9%) without post-injury anxiety. Eighteen (17.0%) were in both anxiety groups. Results supported a significant group x time interaction in participants with pre-existing anxiety for increased diastolic BP (F[1,97] = 5.03, p = 0.03) and VAS (F[1,99] = 5.05, p = 0.03) while controlling for covariates. Participants with pre-existing anxiety (median = 8[4]) and post-injury anxiety (median = 8[5]) completed fewer BCBT stages than those without pre-existing (median = 11[6], p < 0.01) and post-injury (median = 10[6], p = 0.03) anxiety.

Conclusions

Adults with pre-existing and post-injury anxiety experienced altered physiological responses to exercise post-concussion and completed fewer stages of the BCBT. Anxiety should be considered by clinicians when interpreting findings from exercise intolerance tests such as the BCBT.

Trial Registration: www.clinicaltrials.gov; identifier: NCT04549532; https://clinicaltrials.gov/study/NCT04549532