Disclosures: Areeb Chator, MD: No financial relationships or conflicts of interest

Objective: AIM 1: to explore factors associated with new and/or worsening headache during supervised exercise (SE) following sport-related concussion (SRC). AIM 2: to determine how changes in headache during SE are associated with SRC recovery.

Design: Retrospective observational chart review study.Setting : Outpatient Sport Concussion Specialty Clinic.Participants : 102 athletes (43% female; ages 8-34 years) with SRC seen within 30 days of injury between July 2018 and June 2019 by a single specialist provider.

Interventions: All participants completed at least one SE session with an athletic trainer within 30 days of injury.

Main Outcome Measures: New/worsening headache during initial SE session (AIM 1); Recovery, as measured by days from injury until clearance to complete the return to play protocol (AIM 2). Independent variables (IVs) assessed included age, sex, prior concussion history, comorbidities, time from injury to first SE, presence of loss of consciousness, physical exam findings, SCAT symptom severity score, and intensity of SE.

Results: Days from concussion to first SE session (primary IV), history of depression, baseline history of headache, peak heart rate during SE, SCAT symptom severity score, VOMs abnormality and cervical findings on examination were associated with new/worsening headache during SE in univariate logistic regression models (AIM 1). New/worsening headache during the first SE session (primary IV), prior history of concussion, SCAT symptom severity score, and VOMs abnormality on exam were associated with longer SRC recovery in univariate Cox regression models (AIM 2).Conclusions: These findings suggest additional factors beyond time since injury are associated with symptom provocation during SE in athletes with SRC. Furthermore, new/worsening headache during initial SE is associated with slower SRC recovery. These findings can inform prognosis and management in athletes with SRC.

Level of Evidence: Level IV

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/headache-during-supervised-exercise-following-sport-related-concussion/