Sports Health. 2023 May;15(3):410-421. doi: 10.1177/19417381221093556. Epub 2022 Jun 9.
The Dynamic Exertion Test (EXiT) was developed to inform return-to-play (RTP) decision-making following clinical recovery from sport-related concussion (SRC). The purpose of the current study was to document intrarater and test-retest reliability and minimal detectable change (MDC) scores for physiological [heart rate (HR) and blood pressure], performance (change-of-direction task completion time and errors), and clinical outcomes (endorsed symptoms, perceived exertion) of EXiT, and interrater reliability of performance outcomes.
Healthy athletes would exhibit stable physiological responses to the EXiT across visits, demonstrate consistent change-of-direction task completion time between consecutive trials at each visit, and the fastest time (of 2 trials) across visits, and endorse equivocal symptoms and effort across visits.
Cross-sectional, test-retest.
Level 3.
Seventy-nine (female: 34 [43%], 19.6 ± 5.0 years) athletes completed the EXiT at 2 study visits (8.7 ± 4.7 days between visits). Two-way, mixed, intraclass correlation coefficients (ICCs) were used to evaluate intrarater and test-retest reliability. Cronbach's alpha was used to document the internal consistency of symptoms at each visit, and MDC scores were calculated on the physiological, performance, and clinical outcomes.
Measured and percentage of age-estimated maximum HR were reliable following EXiT (ICC = 0.579-0.618). Change-of-direction task completion time (MDC range = 0.75-8.70 s) had good-to-excellent test-retest (ICC = 0.703-0.948) and interrater (ICC = 0.932-0.965) reliability. Symptoms had a high internal consistency at visits 1 ( = 0.894) and 2 ( = 0.805) and were reliable across visits (ICC = 0.588).
The current investigation established test-retest reliability in addition to MDC scores of an objective dynamic exercise assessment among healthy adolescent and adult athletes. The EXiT may be an objective approach to inform RTP decision-making following SRC recovery.
The EXiT is a clinically feasible exertion-based assessment that can be readily administered in a variety of outpatient clinical settings.
动态用力测试（EXiT）旨在为运动相关脑震荡（SRC）后恢复运动（RTP）的决策提供信息。本研究的目的是记录生理（心率[HR]和血压）、表现（变向任务完成时间和错误）和临床结果（认可的症状，感知的用力）的 EXiT 的内部和重测可靠性以及最小可检测变化（MDC）分数，以及表现结果的跨评分者可靠性。
健康运动员在每次就诊时都会对 EXiT 表现出稳定的生理反应，在每次就诊的连续试验中表现出一致的变向任务完成时间，并且在每次就诊时的最快时间（2 次试验），以及在每次就诊时的可疑症状和努力程度。
横截面，重测。
3 级。
79 名（女性：34 [43%]，19.6 ± 5.0 岁）运动员在 2 次研究访问中完成了 EXiT（两次访问之间的 8.7 ± 4.7 天）。使用双向、混合、组内相关系数（ICC）评估内部和重测可靠性。每个就诊时的症状的内部一致性使用 Cronbach's alpha 进行评估，生理、表现和临床结果的 MDC 分数进行计算。
EXiT 后测量和年龄估计最大 HR 的百分比可靠（ICC = 0.579-0.618）。变向任务完成时间（MDC 范围 = 0.75-8.70 s）具有良好至优秀的重测（ICC = 0.703-0.948）和跨评分者（ICC = 0.932-0.965）可靠性。症状在第 1 次就诊时具有高内部一致性（ = 0.894）和第 2 次就诊时（ = 0.805），并且在就诊时可靠（ICC = 0.588）。
本研究除了健康青少年和成年运动员的客观动态运动评估的 MDC 分数外，还建立了重测可靠性。EXiT 可能是 SRC 恢复后 RTP 决策的客观方法。
EXiT 是一种临床可行的基于用力的评估方法，可在各种门诊临床环境中轻松进行管理。
