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9) Residual/Long Term Effects
9.14 Heart rate variability during a cognitive effort in clinically recovered university athletes
  1. Veronik Sicard1,2,
  2. Daphnée Bellemare-Alford2,
  3. Robert Davis Moore3,
  4. Julien Lepine2,
  5. Andrée-Anne Ledoux1,4,
  6. Dave Ellemberg2
  1. 1Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Canada
  2. 2School of Kinesiology and Physical Activity, University of Montreal, Montreal, Canada
  3. 3Arnold School of Public Health, University of South Carolina, Columbia, USA
  4. 4Department of Cellular and Molecular Medicine-Neuroscience, University of Ottawa, Ottawa, Canada

Abstract

Objective 1) Examine the impact of a sports concussion on heart rate variability (HRV) metrics at rest and during a cognitive effort in athletes deemed recovered per usual care; 2) Investigate the association between HRV alterations and cognition.

Design Observational study.

Setting Laboratory.

Participants University athletes who successfully completed step 4 of Zurich return-to-play protocol but had not begun step 5 and teammate controls with no concussion history. History of cardiovascular and neurological disorder, or psychotropic medication/substance use were exclusionary.

Outcome Measures Heart rate and respiration data were recorded during a 5-min rest, followed by a color-shape switch cognitive task with a chest-strap. HRV was analyzed for the last 2-min of rest and 2-min of cognitive effort for time- (SD of NN intervals; root mean square of successive differences) and frequency-domain (low and high frequency), and non-linear approximate entropy.

Main Results 11 concussed [M(SD)age=22.55(2.58); 6 females; M(SD)days=14.64(7.35) post-concussion] and 14 control athletes [M(SD)age=20.57(1.83); 8 females] were included. Heart rate and respiration did not differ between-group, ps>0.648. A 2(Group)×2(Condition) interaction was found for entropy, F(1,23)=5.16, p=0.033, η2=0.183, with concussion group exhibiting greater entropy [M(SD)=0.80(0.09)] during cognitive effort relative to rest [M(SD)=0.71(0.10)], p=0.001, Hedge’s G=1.012[95%CI=0.375,1.626]. The control group did not exhibit this pattern (p=0.286). No other HRV metrics were significant, ps>0.217. Entropy at rest or during cognitive effort were not predictors of accuracy or reaction time on the switch task, ps>0.240.

Conclusions This preliminary data suggests autonomic dysfunction emerges during cognitive effort even when participants are asymptomatic and cleared to return to play.

https://doi.org/10.1136/bjsports-2023-concussion.354

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