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Erschienen in: Clinical Autonomic Research 2/2023

10.04.2023 | Review Article

Autonomic dysfunction and exercise intolerance in concussion: a scoping review

verfasst von: Ryan Pelo, Erin Suttman, Peter C. Fino, Mary M. McFarland, Leland E. Dibble, Melissa M. Cortez

Erschienen in: Clinical Autonomic Research | Ausgabe 2/2023

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Abstract

Purpose

Concussion commonly results in exercise intolerance, often limiting return to activities. Improved understanding of the underlying mechanisms of post-concussive exercise intolerance could help guide mechanism-directed rehabilitation approaches. Signs of altered cardiovascular autonomic regulation—a potential contributor to exercise intolerance—have been reported following concussion, although it is not clear how these findings inform underlying mechanisms of post-concussive symptoms. Systematic summarization and synthesis of prior work is needed to best understand current evidence, allowing identification of common themes and gaps requiring further study. The purpose of this review was to (1) summarize published data linking exercise intolerance to autonomic dysfunction, and (2) summarize key findings, highlighting opportunities for future investigation.

Methods

The protocol was developed a priori, and conducted in five stages; results were collated, summarized, and reported according to PRISMA guidelines. Studies including injuries classified as mild traumatic brain injury (mTBI)/concussion, regardless of mechanism of injury, were included. Studies were required to include both autonomic and exercise intolerance testing. Exclusion criteria included confounding central or peripheral nervous system dysfunction beyond those stemming from the concussion, animal model studies, and case reports.

Results

A total of 3116 publications were screened; 17 were included in the final review.

Conclusion

There was wide variability in approach to autonomic/exercise tolerance testing, as well as inclusion criteria/testing timelines, which limited comparisons across studies. The reviewed studies support current clinical suspicion of autonomic dysfunction as an important component of exercise intolerance. However, the specific mechanisms of impairment and relationship to symptoms and recovery require additional investigation.
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Metadaten
Titel
Autonomic dysfunction and exercise intolerance in concussion: a scoping review
verfasst von
Ryan Pelo
Erin Suttman
Peter C. Fino
Mary M. McFarland
Leland E. Dibble
Melissa M. Cortez
Publikationsdatum
10.04.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Autonomic Research / Ausgabe 2/2023
Print ISSN: 0959-9851
Elektronische ISSN: 1619-1560
DOI
https://doi.org/10.1007/s10286-023-00937-x

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