An objective method to assess and recommend exertion and exercise targets for return to play post concussion

Abstract

ObjectiveThe object of this presentation is to supply the athletic trainer with data concerning a methodology that can be used to aid in designing a cardio conditioning regimen postconcussion as well as an exercise or lifting program postconcussion. This objective measure does not rely on subjective patient reports of symptoms and utilizes a reflex based assessment method.BackgroundSports concussion is a substantial concern for athletic trainers and there is a critical need to objectively and safely allow an athlete to return to play as soon as safely possible. Being able to make cogent recommendations as opposed to empirically trying something that has an intrinsic risk of eliciting symptoms or causing setbacks is urgently needed.Design/MethodsWe present data concerning 65 athletes (mean age 20.8 years) who were assessed. This was done while on an exercise bike going through a progression of exertion levels. The TERC Murmur was listened for every 2 minutes at the traditional carotid artery position.ResultsResults for cardio assessment. 73% of the cardio assessment subjects had a TERC Murmur at a heart rate of 127.2 bpm (± 16 SD). The transient exertion related carotid (TERC) murmur is a murmur that is heard at the carotid arteries during exercise. It normally is heard at around a heart rate of 150, but is heard a lower heart rates in concussion patients.ConclusionsThe clinical advantages of the use of the TERC murmur is that it can be applied by an athletic trainer with the training to listen for a blood pressure. It provides objective information concerning safe heart rates and target heart rate. Being able to safely recommend a means by which an athlete can condition (cardio and or lifting) will accelerate return to play as well as aid in keeping the athlete happy, healthy and engaged.