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Autonomic Function Following Concussion in Youth Athletes: An Exploration of Heart Rate Variability Using 24-hour Recording Methodology
Published on: September 21, 2018
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Orthostatic Vital Signs After Sport-Related Concussion: A Cohort Study.
Andrew R Sas1,2, Michael J Popovich2,3, Aleah Gillenkirk2
1Department of Neurology, Ohio State University Medical Center, Columbus, Ohio, USA.
The American Journal of Sports Medicine
|August 27, 2024
Summary
Athletes with acute sport-related concussion (SRC) show greater changes in heart rate (HR) and blood pressure during orthostatic vital signs (VSs) compared to controls. These autonomic nervous system changes, particularly elevated HR, are more common in younger athletes with SRC.
Area of Science:
- Sports Medicine
- Neurology
- Physiology
Background:
- The 6th International Consensus Statement on Concussion in Sport highlights the importance of assessing autonomic nervous system (ANS) dysfunction using orthostatic vital signs (VSs) post-concussion.
- Limited data exist on the prevalence of ANS dysfunction identified through orthostatic VSs following sport-related concussion (SRC).
Purpose of the Study:
- To compare orthostatic changes in heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) between athletes with acute SRC and healthy control athletes.
- To investigate age- and sex-related differences in these orthostatic changes.
Main Methods:
- A cross-sectional study comparing 133 athletes with acute SRC (<30 days) and 100 control athletes.
- Participants underwent a standard orthostatic vital signs evaluation, measuring HR, SBP, and DBP in supine and standing positions (immediately and 2 minutes).
- Linear and logistic regression analyses were used to compare changes in vital signs (ΔHR, ΔSPB, ΔDBP) and the frequency of positive orthostatic VS changes between groups, controlling for age and sex.
Main Results:
- Athletes with SRC exhibited significantly greater delayed increases in HR (ΔHR) and decreases in SBP (ΔSPB) compared to controls.
- Positive orthostatic HR changes (≥30 bpm increase) were more frequent in athletes with SRC (18% vs 7%).
- In the SRC group, a weak inverse relationship between age and ΔHR was observed, with positive orthostatic HR findings predominantly in child and adolescent subgroups.
Conclusions:
- Acute sport-related concussion is associated with significant orthostatic vital signs changes, primarily sustained heart rate elevations, compared to controls.
- Standard orthostatic vital signs assessment can serve as a valuable clinical biomarker for evaluating autonomic dysfunction after SRC.
- This assessment is particularly relevant for pediatric and adolescent athletes diagnosed with concussion.
Keywords:
autonomic dysfunctionconcussion clinic evaluationorthostatic hypotensionsport-related concussionMore Related Videos
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