Sex Differences in Self-Reported Symptoms Following Aerobic Exercise in Non-Injured Athletes: Implications for Concussion Management Programs

Michael B Gaetz ^1* and Grant L Iverson ²

¹ University of the Fraser Valley, Canada
² University of British Columbia, Canada

^* To whom correspondence should be addressed. E-mail: michael.gaetz{at}ufv.ca.

Accepted 20 December 2008

Abstract

Objective: Following a concussion, when symptoms have decreased substantially at rest, it is recommended that athletes begin light aerobic exercise prior to progressing to sport specific exercise. The British Columbia Concussion Rehabilitation Program (BC-CRP) utilizes a standardized cognitive and exercise test protocol designed to indicate when an athlete should progress to sport-specific exercise following a concussion. The purpose of this study was to document the effects of exercise on symptom reporting in healthy, uninjured, male and female amateur athletes.

Design: Quasi-experimental, pretest-posttest, nonequivalent groups design.

Methods: Prior to the exercise protocol, 45 female and 30 male young amateur athletes completed computerized cognitive testing, symptom ratings, and balance testing. The 15-minute cycle ergometry protocol, conducted at 90 RPM, was as follows: 0-2 minutes at 0 Watts tension, 2-5 minutes at 50W, 5-8 minutes at 100W, 8-11 minutes at 150W, and 11-14 minutes at 200 Watts tension followed by a 1-minute cool down. Following exercise participants completed symptom ratings, balance testing, and perceived exertion ratings. Self-reported symptoms were assessed using an abbreviated version of the Post-Concussion Scale.

Results: Significant increases in self-reported balance problems and numbness and tingling were observed for both genders following aerobic exercise. For female athletes, emotional symptoms such as irritability, sadness, nervousness, and feeling more emotional decreased significantly following aerobic exercise. Headache also decreased in female athletes with no significant change observed for males.

Conclusions: Sex differences exist for symptom reporting following aerobic exercise. Both genders report somatic symptom increases while only females report emotional symptom decreases. The concept of being "asymptomatic" following exercise should be reconsidered to include expected mild increases and decreases for certain symptoms.