Forch Katherine, Pedersen Mangor, Reid Duncan, Towersey Nicola Cm, Olsen Sharon
Auckland University of Technology, Auckland, New Zealand.
Axis Sports Medicine Specialists, Auckland, New Zealand.
BMJ Open Sport Exerc Med. 2025 Apr 28;11(2):e002385. doi: 10.1136/bmjsem-2024-002385. eCollection 2025.
Assessment of recovery from mild traumatic brain injury (mTBI) is complex and challenging. Post-exertion testing, where individuals undergo objective testing following physical exercise, has shown promise in identifying mTBI-related impairments that may not be evident at rest, but could hinder a safe return to sport.
To conduct a systematic review to determine if physical exertion affects objective physiological or sensorimotor tests differently in individuals with mTBI compared with healthy controls.
A systematic search of 11 databases and five trial registries on 30 May 2024 identified reports that: (i) compared individuals aged 12-65 years within 12 months of mTBI against healthy control participants, (ii) investigated the effects of a single session of physical exertion and (iii) collected before, during or after exertion, objective measures of physiological or sensorimotor function. Risk of bias was assessed with the Risk Of Bias In Non-randomized Studies of Interventions tool. Results were analysed descriptively.
The review included 22 studies with 536 participants wih mTBI. Risk of bias was deemed high. At rest, 8/22 (36%) studies detected differences in physiological responses between participants wih mTBI and healthy control participants. During or after exertion, 21/22 (96%) studies detected differences in physiological responses, including cardiovascular, respiratory and cerebral autoregulation.
The findings indicate that objective testing during or after physical exertion can enhance the ability to detect mTBI-related impairments in various physiological parameters, and this concept could be considered when monitoring recovery and return to sport. Further studies are needed.
CRD42023411681.
评估轻度创伤性脑损伤（mTBI）后的恢复情况复杂且具有挑战性。运动后测试是让个体在体育锻炼后接受客观测试，已显示出在识别与mTBI相关的损伤方面具有潜力，这些损伤在休息时可能不明显，但可能会阻碍安全重返运动。
进行一项系统评价，以确定与健康对照相比，体力消耗对mTBI个体的客观生理或感觉运动测试的影响是否不同。
2024年5月30日对11个数据库和5个试验注册库进行系统检索，确定了以下报告：（i）将mTBI后12个月内年龄在12 - 65岁的个体与健康对照参与者进行比较，（ii）研究单次体力消耗的影响，（iii）在体力消耗之前、期间或之后收集生理或感觉运动功能的客观测量数据。使用干预非随机研究中的偏倚风险工具评估偏倚风险。对结果进行描述性分析。
该评价纳入了22项研究，共536名mTBI参与者。偏倚风险被认为很高。在休息时，8/22（36%）的研究检测到mTBI参与者与健康对照参与者之间生理反应的差异。在体力消耗期间或之后，21/22（96%）的研究检测到生理反应的差异，包括心血管、呼吸和脑自动调节。
研究结果表明，体力消耗期间或之后的客观测试可以提高检测mTBI相关的各种生理参数损伤的能力，在监测恢复情况和重返运动时可考虑这一概念。还需要进一步的研究。
PROSPERO注册号：CRD42023411681。
