Memmini Allyssa K, La Fountaine Michael F, Broglio Steven P, Moore Robert D
Michigan Concussion Center, University of Michigan, Ann Arbor.
Department of Physical Therapy, School of Health and Medical Sciences; Institute for Advanced Study of Rehabilitation and Sports Science; Department of Medical Sciences and Neurology, Hackensack Meridian School of Medicine, Seton Hall University, Nutley, NJ.
J Athl Train. 2021 Feb 1;56(2):141-147. doi: 10.4085/1062-6050-0578.19.
Concussion may negatively influence cardiovascular function and the autonomic nervous system, defined by alteration in heart rate variability (HRV). Differences in HRV most commonly emerge during a physical challenge, such as the final steps of the return-to-sport progression.
To assess the effect of concussion history on aspects of cardio-autonomic function during recovery from a bout of submaximal exercise in adolescent male hockey athletes.
Case-control study.
Research laboratory.
Thirty-three male athletes participating in Midget-AAA hockey were divided into those with (n = 15; age = 16 ± 1 years, height = 1.78 ± 0.06 m, mass = 73.9 ± 7.4 kg, 10.5 ± 1.6 years of sport experience, 25.2 ± 18.3 months since last injury) or without (n = 18; age = 16 ± 1 years, height = 1.78 ± 0.05 m, mass = 74.8 ± 7.6 kg, 10.6 ± 1.9 years of sport experience) a concussion history. Those with a concussion history were binned on total count: 1 concussion or 2 or more concussions.
INTERVENTION(S): All athletes underwent 5 minutes of resting HRV assessment, followed by 20 minutes of aerobic exercise at 60% to 70% of their maximal target heart rate and a 9-minute, postexercise HRV assessment.
MAIN OUTCOME MEASURE(S): Heart rate variability measures of mean NN interval, root mean square of successive differences, and standard deviation of NN interval (SDNN).
Group demographic characteristics were not different. When the control and concussed groups were compared, group and time main effects for heart rate recovery, root mean square of successive differences, and SDNN (P values < .01), and an interaction effect for SDNN (P < .05) were demonstrated. Recovery trends for each group indicated that a history of 2 or more concussions may negatively affect cardio-autonomic recovery postexercise.
Our findings suggest that those with more than 1 previous concussion may be associated with a greater risk for long-term dysautonomia. Future use of HRV may provide clinicians with objective guidelines for concussion-management and safe return-to-participation protocols.
脑震荡可能会对心血管功能和自主神经系统产生负面影响，这可通过心率变异性（HRV）的改变来定义。HRV的差异最常出现在身体挑战期间，例如恢复运动进程的最后阶段。
评估脑震荡病史对青少年男性曲棍球运动员次最大运动恢复期间心脏自主神经功能方面的影响。
病例对照研究。
研究实验室。
33名参加青少年甲级曲棍球比赛的男性运动员被分为有（n = 15；年龄 = 16±1岁，身高 = 1.78±0.06米，体重 = 73.9±7.4千克，运动经验10.5±1.6年，上次受伤后25.2±18.3个月）或无（n = 18；年龄 = 16±1岁，身高 = 1.78±0.05米，体重 = 74.8±7.6千克，运动经验10.6±1.9年）脑震荡病史两组。有脑震荡病史的运动员按总数分类：1次脑震荡或2次及以上脑震荡。
所有运动员均接受5分钟的静息HRV评估，随后进行20分钟的有氧运动，运动强度为其最大目标心率的60%至70%，并在运动后进行9分钟的HRV评估。
平均NN间期、连续差值的均方根和NN间期标准差（SDNN）的心率变异性测量值。
两组的人口统计学特征无差异。比较对照组和脑震荡组时，显示出心率恢复、连续差值的均方根和SDNN的组间和时间主效应（P值<0.01），以及SDNN的交互效应（P<0.05）。每组的恢复趋势表明，2次及以上脑震荡病史可能会对运动后心脏自主神经恢复产生负面影响。
我们的研究结果表明，有超过1次既往脑震荡史的人可能与长期自主神经功能障碍的风险增加有关。未来HRV的应用可能为临床医生提供脑震荡管理和安全恢复参与方案的客观指导。
