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Abstract Details

A Supervised Exercise Challenge Detects Dizziness More Frequently Than Symptom Reporting and Vestibular/Ocular-Motor Screening in Adolescent Concussion Patients
Neuro Trauma, Critical Care, and Sports Neurology
P10 - Poster Session 10 (5:30 PM-6:30 PM)
5-002
To evaluate how the provocation of dizziness during a supervised exercise challenge (SEC) in adolescent sport-related concussion patients relates to pre-exercise dizziness reporting and vestibular/ocular-motor screening (VOMS).
Vestibular symptoms (eg dizziness) are common after concussion and have been associated with a prolonged recovery in children. A SEC that features both an aerobic supervised exercise challenge (ASEC) and a dynamic supervised exercise challenge (DSEC) has potential to uncover concussion symptoms that may be missed by basic screening measures, such as symptom reporting and VOMS.
A sample of 68 patient charts from a sport-related concussion clinic were retrospectively reviewed. Patients were athletes under the age of 18 who were diagnosed with a concussion and underwent a SEC as part of their care. Patients completed a standard concussion symptom checklist and underwent VOMS as part of their visit. Symptom provocation during SECs was documented. Descriptive statistics were used to report the frequency of dizziness provocation.
22 patients (32.4%) reported dizziness and 27 patients (39.7%) had an abnormal VOMS at their SEC visit. Dizziness was provoked during a SEC in 14 (30.4%) of the 46 patients who did not report pre-exercise dizziness. Dizziness was provoked in 15 (36.6%) of the 41 patients with a normal VOMS. Dizziness was provoked in 10 (27.8%) of the 36 patients who neither reported dizziness nor had an abnormal VOMS. Of the instances of dizziness provocation in the latter group of patients, 10 (83.3%) occurred during a DSEC compared to 2 (16.7%) during an ASEC.
A significant proportion of adolescent concussion patients experience dizziness provocation during a SEC despite not reporting dizziness prior to exercise and/or having a normal VOMS. A SEC that includes a DSEC is necessary to maximize the detection of dizziness after concussion.
Authors/Disclosures
Michael Popovich, MD (NCAC)
PRESENTER 		Dr. Popovich has nothing to disclose.
Andrew R. Sas, MD, PhD (Ohio State University) Dr. Sas has nothing to disclose.
Andrea Almeida, MD (University of Michigan Department of Neurology) Dr. Almeida has nothing to disclose.
No disclosure on file
No disclosure on file
Matthew T. Lorincz, MD, PhD (University of Michigan-NCAC Neurology) Dr. Lorincz has received personal compensation for serving as an employee of Alexion. Dr. Lorincz has received personal compensation for serving as an employee of Orphalon . Dr. Lorincz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Lorincz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Orphalon . Dr. Lorincz has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Medlink Neurology. The institution of Dr. Lorincz has received research support from Alexion.
James T. Eckner, MD (University of Michigan Dept of PM&R) An immediate family member of Dr. Eckner has received personal compensation for serving as an employee of Autism Alliance of Michigan. The institution of Dr. Eckner has received research support from NIH. The institution of Dr. Eckner has received research support from Department of Defense. Dr. Eckner has received intellectual property interests from a discovery or technology relating to health care. Dr. Eckner has received personal compensation in the range of $500-$4,999 for serving as a CARE Consortium Publication Committee Member with Indiana University. Dr. Eckner has received personal compensation in the range of $0-$499 for serving as a Â鶹´«Ã½Ó³»­al Content Contributor with Move United.