Thematically grouped symptom clusters are present during the acute timeline of post-mild traumatic brain injuries (mTBI), representing clinical profiles called subtypes. Exercise intolerance has not been evaluated within the subtype classifications and, because guidelines support early submaximal aerobic exercise, further knowledge is required in regard to the exercise capabilities among the concussion subtypes. This cross-sectional study (n = 78) aimed to characterize the presence of exercise intolerance within the clinical subtypes and to explore performance on the Buffalo Concussion Treadmill Test (BCTT) in the adult subacute (2-12 weeks post-injury) mTBI population. All participants were evaluated using the BCTT to determine exercise tolerance. We first used the Neurobehavioral Symptom Inventory (NSI) questionnaire to assign each participant a primary subtype(s). To further explore all five subtypes (headache, cognitive, vestibular, ocular motor, and mood), participants were assessed using a multitude of thematically grouped assessments including self-reported questionnaires, clinical tests of vestibular and ocular motor function, balance function, and computerized cognitive testing. Thirty-seven (47%) subjects were exercise tolerant and 41 (53%) were exercise intolerant. There was no difference in the distribution of primary subtypes between the exercise tolerant and exercise intolerant groups. In addition, no significant differences were found between the exercise tolerant and exercise intolerant groups on other thematically grouped subtype assessments. The exercise intolerant group had a significantly higher resting heart rate (HR), lower percentage of age-predicted maximum HR achieved, lower Borg Rate of Perceived Exertion (RPE), and could walk on the treadmill for less time (lower duration) compared with the exercise tolerant group. The current findings suggest that exercise intolerance is common and pervasive across all five mTBI subtypes. A comprehensive mTBI assessment should include evaluation for exercise intolerance regardless of the primary clustering of symptoms and across patient populations. Therefore, early referral to physical therapists, athletic trainers, or medical clinics that can perform the BCTT may be helpful to initiate appropriate exercise prescriptions for patients with mTBI.

中文翻译：

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轻度创伤性脑损伤后运动不耐受发生在成年人群的所有亚型中。

按主题分组的症状群出现在轻度创伤性脑损伤 (mTBI) 后的急性时间段内，代表称为亚型的临床特征。运动不耐受尚未在亚型分类中进行评估，并且由于指南支持早期次最大有氧运动，因此需要进一步了解脑震荡亚型之间的运动能力。这项横断面研究 (n = 78) 旨在表征临床亚型中运动不耐受的存在情况，并探讨成人亚急性（受伤后 2-12 周）mTBI 人群在布法罗脑震荡跑步机测试 (BCTT) 中的表现。所有参与者均使用 BCTT 进行评估以确定运动耐量。我们首先使用神经行为症状量表（NSI）问卷为每个参与者分配一个主要亚型。为了进一步探索所有五种亚型（头痛、认知、前庭、眼运动和情绪），参与者使用多种主题分组评估进行评估，包括自我报告的问卷、前庭和眼运动功能、平衡功能和计算机化的临床测试。认知测试。37 名 (47%) 受试者具有运动耐受性，41 名 (53%) 受试者不耐受运动。运动耐受组和运动不耐受组之间主要亚型的分布没有差异。此外，在其他主题分组的亚型评估中，运动耐受组和运动不耐受组之间没有发现显着差异。与运动不耐受组相比，运动不耐受组的静息心率 (HR) 显着较高，达到年龄预测的最大心率的百分比较低，博格感知用力率 (RPE) 较低，并且可以在跑步机上行走的时间较短（持续时间较短）。运动耐受组。目前的研究结果表明，运动不耐受在所有五种 mTBI 亚型中都很常见且普遍存在。全面的 mTBI 评估应包括对运动不耐受的评估，无论症状的主要聚集性如何以及患者群体的情况如何。因此，尽早转诊至可以进行 BCTT 的物理治疗师、运动训练师或医疗诊所可能有助于为 mTBI 患者制定适当的运动处方。