Publications by authors named "Trevor D Rutschmann"

3 Publications

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Concurrent Validity of a Stationary Cycling Test and Buffalo Concussion Treadmill Test in Adults with Concussion.

J Athl Train 2021 Apr 22. Epub 2021 Apr 22.

1Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.

Context: Following concussion, a multi-faceted assessment is recommended, including tests of physical exertion. The current gold standard for exercise testing following concussion is the Buffalo Concussion Treadmill Test (BCTT); however, there is a lack of validated tests that utilize alternative exercise modalities.

Objective: To assess the feasibility and concurrent validity of a novel cycling test of exertion compared to the BCTT.

Design: Crossover Study Setting: University Sport-Medicine Clinic Patients: Twenty adults (aged 18-60 years) diagnosed with a Sport-Related Concussion Intervention: Participants completed the BCTT and a cycling test of exertion in a random order, approximately 48 hours apart.

Main Outcome Measures: The primary outcome of interest was maximum heart rate [HRmax; beats per minute (bpm)]. Secondary outcomes of interest included whether the participant reached volitional fatigue (yes/no), symptom responsible for test cessation (Post Concussion Symptom Scale), and Symptom Severity on a Visual Scale (/10).

Results: Of the 20 participants, 19 (10 male, 9 female) completed both tests. One participant did not return for the second test and was excluded from the analysis. No adverse events were reported. The median HRmax for the BCTT [171 bpm; (IQR: 139-184bpm)] was not significantly different than the median HRmax for the Cycle [173 bpm; (IQR: 160-182)] (z=-0.63, p=0.53). For both tests, the three most frequently reported symptoms responsible for test cessation were Headache, Dizziness, and Pressure in the head. Of interest, the majority of participants (64%) reported a different symptom responsible for test cessation on each test.

Conclusion: The novel cycling test of exertion achieved similar HRmax and test duration and may be a suitable alternative to the BCTT. Future research to understand the physiological reason for the heterogeneity in symptoms responsible for test cessation is warranted.
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http://dx.doi.org/10.4085/1062-6050-0003.21DOI Listing
April 2021

Changes in exertion-related symptoms in adults and youth who have sustained a sport-related concussion.

J Sci Med Sport 2021 Jan 21;24(1):2-6. Epub 2020 Jun 21.

Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Canada; Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Canada. Electronic address:

Objectives: To identify the symptoms responsible for cessation of exercise testing and evaluate changes in post-concussion symptom scores on the Post-Concussion Symptom Scale (PCSS) from the Sport-Concussion Assessment Tool (SCAT5) immediately, 1-4h, and 6-12h following completion of the Buffalo Concussion Treadmill Test (BCTT) in youth and adults who have sustained a sport-related concussion.

Design: Prospective case-series.

Methods: Individuals who were diagnosed with a sport-related concussion and self-reported difficulties with exertion were referred to perform an exertional treadmill test. Individuals were recruited from a university sports medicine clinic. Change in PCSS symptom severity scores were operationally defined as a change ≥4 points.

Results: Forty-five individuals aged 13-57 years consented to participate. A total of 14/24 (58.3%) female and 13/21 (61.9%) male participants reported an increase in symptom severity scores immediately following the BCTT. At 1-4h, 5/10 (50.0%) males and 5/14 (35.7%) females who completed the PCSS had elevated symptom severity scores compared to pre-exertion. Only 24.2% (3/17 males and 5/16 females) of participants completing the PCSS at 6-12h reported increased symptom severity scores.

Conclusion: Exertional testing is an important component of a multifaceted assessment following concussion; however, previous research evaluating symptom responses to exertion is limited. This study provides evidence to suggest individuals who experience an exacerbation of concussion-associated symptoms after exertion are likely to return to pre-exertion levels within the same day. Future research monitoring symptoms following exertion and throughout recovery should be performed in tandem with physiological measures to better understand the source of symptoms.
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http://dx.doi.org/10.1016/j.jsams.2020.06.005DOI Listing
January 2021

The Association Between Moderate and Vigorous Physical Activity and Time to Medical Clearance to Return to Play Following Sport-Related Concussion in Youth Ice Hockey Players.

Front Neurol 2019 6;10:588. Epub 2019 Jun 6.

Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, AB, Canada.

Prospective cohort study. The recommendations regarding the optimal amount and type of rest for promoting recovery following concussion are based on expert opinion rather than evidence-based guidelines due to current a lack of high-level studies. There is an evident need for more research into the parameters of rest and activity and its effects on recovery from concussion. To evaluate the association between the amount of moderate and vigorous physical activity (MVPA) during the first 3 days following concussion diagnosis and time to medical clearance (days) to return to play in youth ice hockey players. Thirty youth ice hockey players (12-17 years) that were diagnosed with a concussion sustained during ice hockey were recruited to participate. The exposure was the cumulative amount of MVPA (minutes), measured using a waist-worn Actigraph accelerometer. Participants were dichotomized into high (≥148.5) and low (<148.5) activity groups based on the median of cumulative time spent in MVPA over the first 3 days following injury diagnosis. Participants in both the low and high activity group reported to the clinic at a median time of 4 days post-injury (low activity IQR: 3-5 days; high activity IQR: 3-7 days). The low activity group completed a median time of 110.7 min (IQR: 76.2-131.0 min) in MVPA, whereas the high activity had a median of 217.2 min (IQR 184.2-265.2 min) in MVPA. Kaplan Meier survival curves with Log-rank tests of hypothesis revealed the high activity group took significantly more time to be medically cleared to return to play ( = 0.041) compared to the low activity group. The results from this study suggest that more time in MVPA early in the recovery period may result in a greater time to medical clearance to return to full participation in ice hockey. Future research, using valid measures of activity, are required to better understand the relationship between early activity and recovery following concussion in youth.
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http://dx.doi.org/10.3389/fneur.2019.00588DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6563761PMC
June 2019