Appropriate Timing of Administration of Computerized Neurocognitive Testing Following Maximal Exertion

Med Sci Sports Exerc -


Mohler, S. A., Butts, C. L., Sebghati, Z. J., Stephenson-Brown, K. L., McDermott, B. P., Ganio, M. S. and Elbin, R. J..



Computerized neurocognitive testing (CNT) is part of a multi-faceted approach to sport-related concussion assessment. Accurate baseline (pre-injury) CNT scores aid postconcussion management which allows the athlete to serve as their own control. Prior research suggests maximal exertion negatively affects CNT scores immediately following exercise. However, the appropriate wait time for administering CNT following maximal exertion is unknown. PURPOSE: To compare differences in neurocognitive performance and symptoms following maximal exertion with varied recovery intervals in healthy college-aged students. METHODS: A prospective, randomized cross-over, repeated measures design was used for this study. Twenty-six participants (22 ± 2y) completed four experimental visits. Three visits consisted of a maximal effort graded exercise treadmill test (VO2 max), with a prescribed post-exertion rest period, and CNT administration. Prescribed post-exertion recovery intervals were defined as: < .01. RESULTS: There was a significant within-subjects effect for prescribed post-exertion recovery intervals on total symptom scores (Wilks λ = .62, F [3, 23] = 4.64, p = .01, η 2= .38). Total symptom scores were significantly higher at the immediate (p < .001), 10-min (p = .02), and 20-min (p = .05) post-exertion recovery intervals compared to baseline. There were no significant differences for processing speed (p = .05), visual memory (p = .07), verbal memory (p = .06), or reaction time (p = .40). CONCLUSION: Baseline symptom scores were negatively influenced by maximal exertion, and continued to be elevated 20 minutes post-exertion. However, cognitive performance was unaffected. Sports medicine professionals should wait at least 20 minutes following maximal exertion to obtain a more accurate representation of symptoms.

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