The DOI matches its Crossref record; 57 of the 57 references it cites were found in a registry or an index.
Psychological and Physiological Markers of Stress in Concussed Athletes Across Recovery Milestones
Abstract
Background: Sport-related concussions are associated with a range of physical, cognitive, and behavioral disturbances that are highly variable across individuals. Much remains unknown about the effects of sport concussion, and changes in markers of psychological and physiological stress over the recovery timeline. Objective: To examine psychological (mood, stress, sleep quality, and symptoms) and physiological (heart rate variability and salivary cortisol) measures in concussed athletes over clinical recovery milestones. Setting: University athletic program, sport medicine clinic, Canada. Participants: A sample of 52 interuniversity athletes (32 male and 20 female), 26 with concussion and 26 healthy controls. Design: Case-control repeated measures study at 3 time points of the clinical recovery process. Measures were administered to a matched control sample of uninjured athletes as well. Main Measures: Physiological measures were heart rate variability and salivary cortisol; psychological measures were mood, perceived stress, and quality of sleep. Results: Psychological measures were significantly worse for concussed athletes relative to controls at the symptomatic phase (acute injury), but significantly better at return-to-play (RTP). Multivariate analysis of heart rate variability identified main effects of sex and concussion, with reduced high-frequency heart rate variability for females and concussed athletes extending into the post-RTP phase. An interaction effect was also observed, showing the cardiac response of female athletes was more sensitive to concussion compared with males. Conversely, male athletes showed greater suppression of low-frequency heart rate variability associated with mood disturbances. Conclusion: This integrated study of psychological and physiological markers in concussed athletes confirmed the resolution of mood disturbances, symptoms, and sleep quality by RTP, but identified autonomic nervous system disturbances, as measured by depressed heart rate variability beyond RTP.
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“Indeed, sex-related differences in functional magnetic resonance imaging (fMRI) activity, heart rate variability, edema, and intracranial hypertension were reported even in the absence of differences in cognition, post-concussive symptoms, duration of recovery, and GOS. 13,55,56”
From Sex Differences in Traumatic Brain Injury: What We Know and What We Should Know (2019) · cites this paper as [56]
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Sex Differences in Traumatic Brain Injury: What We Know and What We Should Know
Gupte, R. P., Brooks, W. M., Vukas, R. R., Pierce, J. D., & Harris, J. L. (2019) · Journal of Neurotrauma · doi:10.1089/neu.2018.6171 · Cited by 533
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Clinical recovery from concussion–return to school and sport: a systematic review and meta-analysis
Putukian, M., Purcell, L. K., Schneider, K., Black, A. M., Burma, J. S., Chandran, A. S., Boltz, A. J., Master, C. L., Register‐Mihalik, J. K., Anderson, V. A., et al. (2023) · British Journal of Sports Medicine · doi:10.1136/bjsports-2022-106682 · Cited by 184
Pertab, J. L., Merkley, T. L., Cramond, A. J., Cramond, K. M. J., Paxton, H., & Wu, T. C. (2018) · Neurorehabilitation · doi:10.3233/nre-172298 · Cited by 161
The mental health of student-athletes: a systematic scoping review
Kegelaers, J. J., Wylleman, P., Defruyt, S., Praet, L., Stambulova, N. B., Torregrossa, M., Kenttä, G., & Brandt, K. D. (2022) · International Review of Sport and Exercise Psychology · doi:10.1080/1750984x.2022.2095657 · Cited by 149
Metadata
- Authors
- Hutchison, M. G., Mainwaring, L., Senthinathan, A., Churchill, N., Thomas, S., & Richards, D.
- Affiliations
- St. Michael's Hospital (CA)
- University of Toronto (CA)
- ORCID
- Venue
- Journal of Head Trauma Rehabilitation
- Published
- 2017-05
- Volume
- 32
- Issue
- 3
- Pages
- E38-E48
- ISSN
- 0885-9701 (ISSN-L)
- OpenAlex
- W2513771625
- Cited by
- 106
- References
- 57
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 10 · 2023: 10 · 2022: 12 · 2021: 18 · 2020: 13 · 2019: 8 · 2018: 13 · 2017: 8
- FWCI
- 9.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Head Trauma Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Canadian Institutes of Health Research (2012-ABI-CAT1-971)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports injuries and prevention
- Keywords
- sports-related concussion, athletes, return to sport, heart rate variability, salivary cortisol, stress, mood disturbance, sleep quality, autonomic nervous system, sex differences
- MeSH terms
- Adult, Age Factors, Athletic Injuries, Brain Concussion, Canada, Female, Follow-Up Studies, Heart Rate, Humans, Hydrocortisone, Male, Neuropsychological Tests, Prognosis, Saliva, Sex Factors, Sleep Wake Disorders, Sports Medicine, Stress, Psychological, Biomarkers, Multivariate Analysis, Logistic Models, Case-Control Studies, Risk Assessment, Mood Disorders, Recovery of Function, Young Adult, Self Report
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