60 (14A) Sex differences in concussion mechanisms of injury: a limbic matars consortium investigation
Purpose We investigated the relationship between autonomic markers in PPCS patients who are exercise tolerant (ET) and exercise intolerant (EI) with standardized exertional testing.Methods Retrospective study of 95 pediatric patients, ages 9-19, with 213 clinical encounters for PPCS.Patients underwent standardized exertional testing.Clinical markers were collected before, during and after exercise and were used to determine exercise tolerance.These markers included signs/symptoms and orthostatic measurements.The onset of signs/symptoms and/or cardiovagal dysautonomia determined EI.Results Of the 213 visits with standardized exertional testing, 99 (46.48%)experienced EI while 114 (53.52%) did not.There was a significant difference in systolic BP change between EI and ET exertional testing -4.25 mmHg, and 1.30 mmHg respectively (p = 0.00496).There was a significant difference in diastolic BP change between EI and ET patients 2.29 mmHg, and 8.61 mmHg respectively (p = 0.0000423).There was no significant difference in HR change between EI and ET patients 17.26, and 13.68 mmHg respectively (p = 0.0534).Conclusions There is a statistically significant difference in post-exertional testing orthostatic BP measurements in EI compared to ET visits.HR change demonstrates a trend towards significance.Orthostatic measurements are a valuable aid for guiding management and autonomic recovery of pediatric patients with PPCS.
Authors
- Jessica Gill (ORCID: https://orcid.org/0000-0002-3689-7441)
- Melissa A. Fraser (ORCID: https://orcid.org/0000-0002-5753-8798)
- Jacob E. Resch (ORCID: https://orcid.org/0000-0001-6031-3197)
- Michael J. Larson (ORCID: https://orcid.org/0000-0002-8199-8065)
- Kristin Wilmoth (ORCID: https://orcid.org/0000-0003-4192-8756)
- Landon B. Lempke (ORCID: https://orcid.org/0000-0003-0007-1362)
- Patricia M. Kelshaw (ORCID: https://orcid.org/0000-0002-0523-0281)
- Daniel J. Rosenblum (ORCID: https://orcid.org/0000-0003-2525-7366)
- Thayne A. Munce (ORCID: https://orcid.org/0000-0001-6297-7827)
- Elisabeth A. Wilde (ORCID: https://orcid.org/0000-0002-9839-4428)
- David X. Cifu (ORCID: https://orcid.org/0000-0003-1600-9387)
- Thomas R. Campbell (ORCID: https://orcid.org/0000-0003-0879-2308)
- Emily McIndoe
- Melissa K. Kossman (ORCID: https://orcid.org/0000-0001-6653-1363)
- Thomas G. Bowman (ORCID: https://orcid.org/0000-0002-0034-2946)
- Samuel R Walton
- Erica Beilder
Institutions
- Brigham Young University (US)
- Johns Hopkins University (US)
- Augustana University (US)
- University of New Hampshire (US)
- Duquesne University (US)
- Virginia Commonwealth University (US)
- University of Lynchburg (US)
- University of Utah (US)
- Johns Hopkins Medicine (US)
- Veterans Health Administration (US)
- Hunter Holmes McGuire VA Medical Center (US)
- Sanford Research (US)
- Southwestern Medical Center (US)
- George E. Wahlen Department of VA Medical Center (US)
- University of Southern Mississippi (US)
- University of Virginia (US)
- Old Dominion University (US)
- The University of Texas Southwestern Medical Center (US)
Publication Details
- Published
- 2025-05-01
- DOI
- https://doi.org/10.1136/bmjsem-2025-concussion.60
- Primary Topic
- Traumatic Brain Injury Research
- Type
- article
- Field-Weighted Citation Impact
- 0.00