Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Sports Science, Medicine and Rehabilitation
Published in: BMC Sports Science, Medicine and Rehabilitation 1/2024

Open Access 01-12-2024 | Research

A treadmill running research protocol to assess dynamic visual acuity and balance for athletes with and without recent concussion history

Authors: Katelyn M. Mitchell, Kristine N. Dalton, Michael E. Cinelli

Published in: BMC Sports Science, Medicine and Rehabilitation | Issue 1/2024

Login to get access

Abstract

Athletes interpret dynamic visual scenes quickly and accurately during physical exertion. It is important to understand how increased exertion may impact vision and cognition following sport-related concussion (SRC).
Purpose To examine the effect of a treadmill running research protocol on the assessment of dynamic visual acuity (DVA) and balance for athletes with and without recent history of SRC.
Methods Varsity athletes following recent SRC (CONC=12) were compared to athletes without SRC (ATHLETE=19). The DVA task presented a Tumbling ‘E’ target in four possible orientations during random walk (RW) or horizontal (H) motion at a speed of 30°/s. Participants performed DVA trials standing on a force plate (1000Hz) at four time points: 1) pre-exercise (PRE-EX), 2) immediately (POST1), 3) 10-minutes (POST10), and 4) 20-minutes post- exercise (POST20). Performance was calculated as a change in DVA score from PRE-EX and median response time (RT, ms). Balance control was analyzed using the root mean square of centre of pressure displacement (dCOP).
Results Both groups maintained DVA scores for both motion types and exhibited immediate exercise-induced benefits on RT. Both groups had similar change in balance control strategy following treadmill exercise.
Conclusion Both groups elicited similar exercise-induced benefits on DVA following exercise. A repeated measures assessment following vigorous exercise may provide meaningful insights about visual and neurocognitive functions for athletes returning to sport following concussion.
Appendix
Available only for authorised users
Literature
1.
Dubois R, Paillard T, Lyons M, McGrath D, Maurelli O, Prioux J. Running and metabolic demands of elite rugby union assessed using traditional, metabolic power, and heart rate monitoring methods. J Sports Sci Med. 2017;16(1):84–92.PubMedPubMedCentral
2.
Green H, Bishop P, Houston M, McKillop R, Norman R, Stothart P. Time-motion and physiological assessments of ice hockey performance. J Appl Physiol. 1976;40(2):159–63.PubMedCrossRef
3.
Broglio S, Sosnoff JJ, Ferrara MS. The relationship of athlete-reported concussion symptoms and objective measures of neurocognitive function and postural control. Clin J Sport Med. 2009;19(5):377–82.PubMedCrossRef
4.
Covassin T, Elbin RJ, Harris W, Parker T, Kontos A. The role of age and sex in symptoms, neurocognitive performance, and postural stability in athletes after concussion. Am J Sports Med. 2012;40(6):1303–12.PubMedCrossRef
5.
Dobson JL, Yarbrough MB, Perez J, Evans K, Buckley T. Sport-related concussion induces transient cardiovascular autonomic dysfunction. Am J Physiol-Regul Integr Comp Physiol. 2017;312(4):R575-84.PubMedCrossRef
6.
McCrory P, Meeuwisse W, Dvorak J, Aubry M, Bailes J, Broglio S, et al. Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med. 2017;51(11):838.PubMedCrossRef
7.
Murray NG, Szekely B, Islas A, Munkasy B, Gore R, Berryhill M, et al. Smooth pursuit and saccades after sport-related concussion. J Neurotrauma. 2020;37(2):340–6.PubMedCrossRef
8.
Powers KC, Kalmar JM, Cinelli ME. Recovery of static stability following a concussion. Gait Posture. 2014;39(1):611–4.PubMedCrossRef
9.
Patricios JS, Schneider KJ, Dvorak J, Ahmed OH, Blauwet C, Cantu RC, et al. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport–Amsterdam, October 2022. Br J Sports Med. 2023;57(11):695–711.PubMedCrossRef
10.
Miner D, Harper B. Combined neurocognitive and exercise tolerance testing improves objectivity of buffalo concussion treadmill test. J Sport Rehabil. 2023;1(aop):1–7.
11.
12.
Fino PC, Weightman MM, Dibble LE, Lester ME, Hoppes CW, Parrington L, et al. Objective dual-task turning measures for return-to-duty assessment after mild traumatic brain injury: the ReTURN study protocol. Front Neurol. 2021;11. Cited 2023 Jul 13. Available from: https://​www.​frontiersin.​org/​articles/​https://​doi.​org/​10.​3389/​fneur.​2020.​544812
13.
Baker CS, Cinelli ME. Visuomotor deficits during locomotion in previously concussed athletes 30 or more days following return to play. Physiol Rep. 2014;2(12):e12252.
14.
Broglio S, Macciocchi SN, Ferrara MS. Neurocognitive performance of concussed athletes when symptom free. J Athl Train. 2007;42(4):504–8.PubMedPubMedCentral
15.
Howell DR, Buckley TA, Lynall RC, Meehan WP. Worsening dual-task gait costs after concussion and their association with subsequent sport-related injury. J Neurotrauma. 2018;35(14):1630–6.PubMedCrossRef
16.
Mitchell KM, Cinelli ME. Balance control in youth hockey players with and without a history of concussions during a lower limb reaching task. Clin Biomech. 2019;1(67):142–7.CrossRef
17.
Sicard V, Caron G, Moore RD, Ellemberg D. Post-exercise cognitive testing to assess persisting alterations in athletes with a history of concussion. Brain Inj. 2021;35(8):978–85.PubMedCrossRef
18.
Wilkerson GB. Neurocognitive reaction time predicts lower extremity sprains and strains. Int J Athl Ther Train. 2012;17(6):4–9.CrossRef
19.
20.
Brooks MA, Peterson K, Biese K, Sanfilippo J, Heiderscheit BC, Bell DR. Concussion increases odds of sustaining a lower extremity musculoskeletal injury after return to play among collegiate athletes. Am J Sports Med. 2016;44(3):742–7.PubMedCrossRef
21.
Cross M, Kemp S, Smith A, Trewartha G, Stokes K. Professional Rugby Union players have a 60% greater risk of time loss injury after concussion: a 2-season prospective study of clinical outcomes. Br J Sports Med. 2016;50(15):926.PubMedCrossRef
22.
Eagle SR, Kontos AP, Pepping GJ, Johnson CD, Sinnott A, LaGoy A, et al. Increased risk of musculoskeletal injury following sport-related concussion: a perception–action coupling approach. Sports Med. 2020;50:15–23.
23.
Herman DC, Jones D, Harrison A, Moser M, Tillman S, Farmer K, et al. Concussion may increase the risk of subsequent lower extremity musculoskeletal injury in collegiate athletes. Sports Med. 2017;47(5):1003–10.PubMedPubMedCentralCrossRef
24.
Lynall RC, Mauntel TC, Pohlig RT, Kerr ZY, Dompier TP, Hall EE, et al. Lower extremity musculoskeletal injury risk after concussion recovery in high school athletes. J Athl Train. 2017;52(11):1028–34.PubMedPubMedCentralCrossRef
25.
Roach MH, Aderman MJ, Ross JD, Kelly TF, Malvasi SR, Posner MA, et al. Risk of upper extremity musculoskeletal injury within the first year after a concussion. Orthop J Sports Med. 2023;11(5):23259671231163570.PubMedPubMedCentral
26.
Hillman C, Snook EM, Jerome GJ. Acute cardiovascular exercise and executive control function. Int J Psychophysiol. 2003;48(3):307–14.PubMedCrossRef
27.
Kamijo K, Nishihira Y, Higashiura T, Kuroiwa K. The interactive effect of exercise intensity and task difficulty on human cognitive processing. Int J Psychophysiol. 2007;65(2):114–21.PubMedCrossRef
28.
29.
Olson RL, Chang YK, Brush CJ, Kwok AN, Gordon VX, Alderman BL. Neurophysiological and behavioral correlates of cognitive control during low and moderate intensity exercise. NeuroImage. 2016;1(131):171–80.CrossRef
30.
Tsai CL, Chen FC, Pan CY, Wang CH, Huang TH, Chen TC. Impact of acute aerobic exercise and cardiorespiratory fitness on visuospatial attention performance and serum BDNF levels. Psychoneuroendocrinology. 2014;1(41):121–31.CrossRef
31.
Griffin ÉW, Mullally S, Foley C, Warmington SA, O’Mara SM, Kelly ÁM. Aerobic exercise improves hippocampal function and increases BDNF in the serum of young adult males. Physiol Behav. 2011;104(5):934–41.PubMedCrossRef
32.
Reycraft JT, Islam H, Townsend LK, Hayward GC, Hazell TJ, Macpherson REK. Exercise intensity and recovery on circulating brain-derived neurotrophic factor. Med Sci Sports Exerc. 2020;52(5):1210–7.PubMedCrossRef
33.
Sleiman SF, Henry J, Al-Haddad R, El Hayek L, Abou Haidar E, Stringer T, et al. Exercise promotes the expression of brain derived neurotrophic factor (BDNF) through the action of the ketone body β-hydroxybutyrate. Elmquist JK, editor. eLife. 2016;5:e15092.
34.
Gottschalk W, Pozzo-Miller LD, Figurov A, Lu B. Presynaptic modulation of synaptic transmission and plasticity by brain-derived neurotrophic factor in the developing hippocampus. J Neurosci. 1998;18(17):6830–9.PubMedPubMedCentralCrossRef
35.
36.
Vaynman S, Ying Z, Gomez-Pinilla F. Hippocampal BDNF mediates the efficacy of exercise on synaptic plasticity and cognition. Eur J Neurosci. 2004;20(10):2580–90.PubMedCrossRef
37.
Mychasiuk R, Hehar H, Ma I, Candy S, Esser MJ. Reducing the time interval between concussion and voluntary exercise restores motor impairment, short-term memory, and alterations to gene expression. Eur J Neurosci. 2016;44(7):2407–17.PubMedCrossRef
38.
Griesbach GS, Hovda DA, Gomez-Pinilla F. Exercise-induced improvement in cognitive performance after traumatic brain injury in rats is dependent on BDNF activation. Brain Res. 2009;8(1288):105–15.CrossRef
39.
Hutchison MG, Battista APD, Lawrence DW, Pyndiura K, Corallo D, Richards D. Randomized controlled trial of early aerobic exercise following sport-related concussion: Progressive percentage of age-predicted maximal heart rate versus usual care. PLOS One. 2022;17(12):e0276336.PubMedPubMedCentralCrossRef
40.
Lawrence DW, Richards D, Comper P, Hutchison MG. Earlier time to aerobic exercise is associated with faster recovery following acute sport concussion. PLoS One. 2018;13(4):e0196062.PubMedPubMedCentralCrossRef
41.
Leddy JJ, Haider MN, Hinds AL, Darling S, Willer BS. A preliminary study of the effect of early aerobic exercise treatment for sport-related concussion in males. Clin J Sport Med. 2019;29(5):353–60.PubMedPubMedCentralCrossRef
42.
Moran RN, Murray NG, Esco MR, Dobbs W, McAllister-Deitrick J. Effects of exercise on symptoms, vestibular/ocular motor screening and postural stability in a college-aged sample. Concussion. 2020;5(2):CNC73.PubMedPubMedCentralCrossRef
43.
Popovich M, Almeida A, Lorincz M, Eckner JT, Freeman J, Streicher N, et al. Does exercise increase vestibular and ocular motor symptom detection after sport-related concussion? J Neurol Phys Ther. 2021;45(3):214–20.PubMedCrossRef
44.
45.
Yee A, Thompson B, Irving E, Dalton K. Athletes demonstrate superior dynamic visual acuity. Optom Vis Sci. 2021;98(7):777–82.PubMedCrossRef
46.
Redondo B, Jiménez R, Molina R, Dalton K, Vera J. Effects of caffeine ingestion on dynamic visual acuity: a placebo-controlled, double-blind, balanced-crossover study in low caffeine consumers. Psychopharmacology. 2021;238(12):3391–8.PubMedPubMedCentralCrossRef
47.
Anzalone AJ, Blueitt D, Case T, McGuffin T, Pollard K, Garrison JC, et al. A Positive Vestibular/Ocular Motor Screening (VOMS) is associated with increased recovery time after sports-related concussion in youth and adolescent athletes. Am J Sports Med. 2017;45(2):474–9.PubMedCrossRef
48.
Mucha A, Collins MW, Elbin RJ, Furman JM, Troutman-Enseki C, DeWolf RM, et al. A brief Vestibular/Ocular Motor Screening (VOMS) assessment to evaluate concussions: preliminary findings. Am J Sports Med. 2014;42(10):2479–86.PubMedPubMedCentralCrossRef
49.
Bailey IL, Lovie-Kitchin JE. Visual acuity testing. From the laboratory to the clinic. Vis Res. 2013;90:2–9.PubMedCrossRef
50.
Kuo HK, Kuo MT, Tiong IS, Wu PC, Chen YJ, Chen CH. Visual acuity as measured with Landolt C chart and Early Treatment of Diabetic Retinopathy Study (ETDRS) chart. Graefes Arch Clin Exp Ophthalmol. 2011;249(4):601–5.PubMedCrossRef
51.
Casson EJ, Racette L. Vision standards for driving in Canada and the United States. A review for the Canadian Ophthalmological Society. Can J Ophthalmol. 2000;35(4):192–203.PubMedCrossRef
52.
Rubin GS, Muñoz B, Bandeen-Roche K, West SK. Monocular versus Binocular Visual Acuity as Measures of Vision Impairment and Predictors of Visual Disability. Investig Ophthal Vis Sci. 2000;41(11):3327–34.
53.
Borg E, Borg G, Larsson K, Letzter M, Sundblad BM. An index for breathlessness and leg fatigue. Scand J Med Sci Sports. 2010;20(4):644–50.PubMedCrossRef
54.
55.
Hutchinson MJ, Kouwijzer I, de Groot S, Goosey-Tolfrey VL. Comparison of two Borg exertion scales for monitoring exercise intensity in able-bodied participants, and those with paraplegia and tetraplegia. Spinal Cord. 2021;59(11):1162–9.PubMedPubMedCentralCrossRef
56.
Lee O, Jung JW, 정진욱이온. Validity of Borg’s Category Ratio 10 Scale during Maximal-graded Exercise Testing. Exerc Sci. 2016;25(2):92–9.CrossRef
57.
Zamunér AR, Moreno MA, Camargo TM, Graetz JP, Rebelo ACS, Tamburús NY, et al. Assessment of Subjective Perceived Exertion at the Anaerobic Threshold with the Borg CR-10 Scale. J Sports Sci Med. 2011;10(1):130–6.PubMedPubMedCentral
58.
Sánchez-González MC, García-Oliver R, Sánchez-González JM, Bautista-Llamas MJ, Jiménez-Rejano JJ, De-Hita-Cantalejo C. Minimum Detectable Change of Visual Acuity Measurements Using ETDRS Charts (Early Treatment Diabetic Retinopathy Study). Int J Environ Res Public Health. 2021;18(15):7876.PubMedPubMedCentralCrossRef
59.
Schielzeth H, Dingemanse NJ, Nakagawa S, Westneat DF, Allegue H, Teplitsky C, et al. Robustness of linear mixed-effects models to violations of distributional assumptions. Methods Ecol Evol. 2020;11(9):1141–52.CrossRef
60.
Allard F, Brawley LR, Deakin J, Elliott D. The effect of exercise on visual attention performance. Hum Perform. 1989;2(2):131–45.
61.
Ferris LT, Williams JS, Shen CL. The effect of acute exercise on serum brain-derived neurotrophic factor levels and cognitive function. Med Sci Sports Exerc. 2007;39(4):728–34.PubMedCrossRef
62.
Shaw BS, Breukelman G, Millard L, Moran J, Brown G, Shaw I. Effects of a maximal cycling all-out anaerobic test on visual performance. Clin Exp Optom. 2023;106(7):777–82.PubMedCrossRef
63.
Sicard V, Caron G, Moore RD, Ellemberg D. Prevalence of post-exertion cognitive test failure in varsity athletes with a history of concussion. Arch Clin Neuropsychol. 2019;34(5):791.CrossRef
64.
Delignières D, Brisswalter J. Influence of physical exercise on choice reaction time in sport experts: The mediating role of resource allocation. J Hum Mov Stud. 1994;27(4):173–88.
65.
Fontana FE, Mazzardo O, Mokgothu C, Furtado O, Gallagher JD. Influence of exercise intensity on the decision-making performance of experienced and inexperienced soccer players. J Sport Exerc Psychol. 2009;31(2):135–51.PubMedCrossRef
66.
Thorpe S, Fize D, Marlot C. Speed of processing in the human visual system. Nature. 1996;381(6582):520–2.PubMedCrossRef
67.
Jolij J, Scholte HS, van Gaal S, Hodgson TL, Lamme VAF. Act quickly, decide later: long-latency visual processing underlies perceptual decisions but not reflexive behavior. J Cogn Neurosci. 2011;23(12):3734–45.PubMedCrossRef
68.
Scharnowski F, Rüter J, Jolij J, Hermens F, Kammer T, Herzog MH. Long-lasting modulation of feature integration by transcranial magnetic stimulation. J Vision. 2009;9(6):1.CrossRef
69.
Brisswalter J, Arcelin R, Audiffren M, Delignières D. Influence of physical exercise on simple reaction time: effect of physical fitness. Percept Mot Skills. 1997;85(3):1019–27.PubMedCrossRef
70.
Fickling SD, Smith AM, Stuart MJ, Dodick DW, Farrell K, Pender SC, et al. Subconcussive brain vital signs changes predict head-impact exposure in ice hockey players. Brain Commun. 2021;3(2):fcab019.PubMedPubMedCentralCrossRef
71.
Herman DC, Zaremski JL, Vincent HK, Vincent KR. Effect of neurocognition and concussion on musculoskeletal injury risk. Curr Sports Med Rep. 2015;14(3):194–9.PubMedCentralCrossRef
72.
Moore RD, Lepine J, Ellemberg D. The independent influence of concussive and sub-concussive impacts on soccer players’ neurophysiological and neuropsychological function. Int J Psychophysiol. 2017;1(112):22–30.CrossRef
73.
Koga H, Nakamae A, Shima Y, Iwasa J, Myklebust G, Engebretsen L, et al. Mechanisms for noncontact anterior cruciate ligament injuries: knee joint kinematics in 10 injury situations from female team handball and basketball. Am J Sports Med. 2010;38(11):2218–25.PubMedCrossRef
74.
Villa FD, Buckthorpe M, Grassi A, Nabiuzzi A, Tosarelli F, Zaffagnini S, et al. Systematic video analysis of ACL injuries in professional male football (soccer): injury mechanisms, situational patterns and biomechanics study on 134 consecutive cases. Br J Sports Med. 2020;54(23):1423–32.PubMedCrossRef
75.
76.
Swanik CB, Covassin T, Stearne DJ, Schatz P. The relationship between neurocognitive function and noncontact anterior cruciate ligament injuries. Am J Sports Med. 2007;35(6):943–8.PubMedCrossRef
77.
Nardone A, Tarantola J, Galante M, Schieppati M. Time course of stabilometric changes after a strenuous treadmill exercise. Arch Phys Med Rehabil. 1998;79(8):920–4.PubMedCrossRef
78.
Hashiba M. Transient change in standing posture after linear treadmill locomotion. Japan J Physiol. 1998;48(6):499–504.CrossRef
79.
Bove M, Faelli E, Tacchino A, Lofrano F, Cogo CE, Ruggeri P. Postural control after a strenuous treadmill exercise. Neurosci Lett. 2007;418(3):276–81.PubMedCrossRef
80.
David P, Terrien J, Petitjean M. Postural- and respiratory-related activities of abdominal muscles during post-exercise hyperventilation. Gait Posture. 2015;41(4):899–904.PubMedCrossRef
Metadata
Title
A treadmill running research protocol to assess dynamic visual acuity and balance for athletes with and without recent concussion history
Authors
Katelyn M. Mitchell
Kristine N. Dalton
Michael E. Cinelli
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Sports Science, Medicine and Rehabilitation / Issue 1/2024
Electronic ISSN: 2052-1847
DOI
https://doi.org/10.1186/s13102-024-00900-x

Other articles of this Issue 1/2024

BMC Sports Science, Medicine and Rehabilitation 1/2024 Go to the issue

Research

Reliability and validity of self-report questions for assessing levels of physical activity and sedentary time in adult childhood cancer survivors

Research

Effects of six-week stroboscopic training program on visuomotor reaction speed in goal-directed movements in young volleyball players: a study focusing on agility performance

Research

Effects of single and repeated bouts of flywheel exercise on jump performance and muscle damage in athletes and non athletes

Research

Sex differences in the physiological responses to cardiac rehabilitation: a systematic review

Research

Force plate assessments in reconnaissance marine training company

Research

Lower extremity movement quality in professional team sport athletes: Inter-rater agreement and relationships with quantitative results from the corresponding pattern