Role of anxiety in exercise intolerance and autonomic nervous system dysfunction post-concussion
Aaron J Zynda1, Alicia M Trbovich2, Faith Kehinde2
1Department of Orthopaedic Surgery, University of Pittsburgh Medical Center Sports Medicine Concussion Program, University of Pittsburgh, Pittsburgh, PA, USA. ajz61@pitt.edu.
Summary
Adults with anxiety, both pre-existing and post-injury, show altered autonomic nervous system responses and complete fewer stages on the Buffalo Concussion Bike Test (BCBT). Clinicians should consider anxiety when interpreting exercise intolerance test results.
Area of Science:
- Neuroscience
- Sports Medicine
- Psychology
Background:
- Anxiety is a common comorbidity following concussion.
- The autonomic nervous system (ANS) plays a crucial role in the physiological response to exercise.
- Understanding how anxiety affects ANS response post-concussion is vital for accurate diagnosis and management.
Purpose of the Study:
- To compare autonomic nervous system (ANS) response using the Buffalo Concussion Bike Test (BCBT) in adult post-concussion patients.
- To investigate differences between patients with and without pre-existing and post-injury anxiety.
Main Methods:
- Cross-sectional cohort study involving 106 adult participants (ages 18-49) from a concussion randomized controlled trial.
- Participants completed the BCBT, with measurements including heart rate, blood pressure, and perceived exertion.
- Outcomes assessed were the number of BCBT stages completed and physiological responses.
Main Results:
- Participants with pre-existing anxiety showed increased diastolic blood pressure and perceived exertion during the test.
- Both pre-existing and post-injury anxiety groups completed significantly fewer BCBT stages compared to those without anxiety.
- A significant group-by-time interaction was observed for diastolic blood pressure and perceived exertion in the pre-existing anxiety group.
Conclusions:
- Pre-existing and post-injury anxiety are associated with altered physiological responses to exercise post-concussion.
- Anxiety impacts performance on exercise intolerance tests like the BCBT.
- Clinicians must consider the presence of anxiety when interpreting results from exercise-based concussion assessments.
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