Browsing by Author "Miutz, Lauren Nicole"

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    Evaluating different methodological approaches to inform physiologically-based exercise strategies to improve recovery following sport-related concussion
    (2022-06) Miutz, Lauren Nicole; Emery, Carolyn; Smirl, Jonathan; Brassard, Patrice; Phillips, Aaron
    After sustaining a sport-related concussion (SRC), following a brief initial rest period (24-48 hours), a gradual return to physical exertion with exercise performed below symptom threshold is recommended.1,2 However, there is currently a paucity of literature examining how physical activity (PA) should be performed during the recovery phase following a concussion; including recommendations on intensity, duration, and modality. Research has shown that physical exertion can exacerbate symptoms (e.g., headache, balance, vision impairments, dizziness) and cerebral blood flow (CBF) regulatory mechanisms can be altered,3,4 which may impact one’s quality of life and ability to return to sport.2,5 Combined, these findings provide a potential physiological explanation for the mechanisms of clinical symptom exacerbation commonly reported during exertion following a concussion.6 Evaluating the methodologies using a physiologically-informed approach informed a further the understanding of the underlying mechanisms of clinical symptom exacerbation at rest and during PA, which is vital in creating evidence-based recovery management processes following SRC. In this dissertation, the evidence related to how PA affects recovery following an SRC in adolescents was systematically reviewed. Second, appropriate attachment site for objectively measured sleep and PA metrics was examined in adolescents. Next, a newly developed cycle protocol was compared physiologically to the Buffalo Concussion Treadmill Test in uninjured adults. Finally, CBF responses to progressively increasing lower body negative pressure during moderate intensity aerobic exercise in healthy young adults was investigated. The overall findings from this research enhanced the understanding of physiological measures associated with exertion (including modality and postural considerations) in an uninjured population.
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    Feasibility, reliability and concurrent validity of a field test of exertion in high school students
    (2019-07-02) Miutz, Lauren Nicole; Schneider, Kathryn J.; Emery, Carolyn A.; Jordan, Matthew J.; Black, Amanda M.
    Study Design: Test-retest reliability and concurrent validation study. Background: Exertional testing is an important component of a multifaceted assessment following concussion, however the literature evaluating a non-laboratory field test of exertion is limited. Objectives: 1) To evaluate the feasibility of a field test of aerobic capacity (modified shuttle run test - mSRT), 2) to examine the test-retest reliability of the mSRT, and 3) to evaluate the concurrent validity of a mSRT compared to the Buffalo Concussion Treadmill Test (BCTT) in uninjured high school students. Methods: Sixty uninjured adolescent males enrolled in high school sports performance courses (age 15-16 years) completed the mSRT twice (one week apart) and the BCTT once. Heart rate (HR) utilizing a Polar HR monitor, self-reported rating of perceived exertion (RPE), and overall symptoms were assessed. Results: The mSRT was feasible in high school students, with 95% of participants (n=57) completing all three testing sessions and no adverse events reported. The mSRT had a moderate level (ICC=0.68) of test-retest reliability. The mean difference between peak heart rates on the mSRT1 and BCTT was -2.62 (95% CI -7.14, 1.91). Median HRpeak (187 bpm), RPEpeak (18), and stage achieved (23) was highest following the BCTT. Fatigue or low energy was the most commonly reported symptom following all three testing sessions. Conclusions: This study found that there were similar responses to BCTT and mSRT in uninjured adolescent male participants. Further research to better understand the reliability and concurrent validity in a more heterogeneous sample, including female participants and participants following concussion, is warranted.