Combined Neurocognitive and Exercise Tolerance Testing Improves Objectivity of Buffalo Concussion Treadmill Test

Area of Science:

• Sports Medicine
• Neuroscience
• Exercise Physiology

Background:

• The Buffalo Concussion Treadmill Test (BCTT) is standard for concussion exercise prescription and return-to-play decisions.
• A limitation of BCTT is reliance on subjective symptom reporting, as concussion symptoms are often underreported.
• Objective neurocognitive assessment combined with exercise tolerance testing can objectively identify individuals needing further concussion management.

Purpose of the Study:

• To investigate the impact of provocative exercise testing on neurocognitive assessment battery performance.
• To establish baseline neurocognitive responses to exercise in healthy individuals.

Main Methods:

• Prospective cohort study with a pretest/posttest design.
• 30 healthy participants completed a neurocognitive assessment battery (including Stroop Test, working memory, attention, and processing speed) in single-task and dual-task conditions.
• Assessments were conducted at baseline and immediately after the standard BCTT protocol.

Main Results:

• Maximal exercise testing on the BCTT significantly improved time-based performance in single-task and dual-task neurocognitive assessments (P < .05).
• Specific cognitive domains showing improvement included concentration-reverse digits, Stroop congruent, and Stroop incongruent tasks.
• Participants reached an average of 93.97% of maximum heart rate with a perceived exertion of 18.6.

Conclusions:

• Healthy individuals exhibit enhanced neurocognitive performance after BCTT exercise tolerance testing.
• Understanding these normal responses allows for more objective monitoring of concussion recovery.
• This approach may help clinicians better assess readiness for return to play.