Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Jørgen Feldbæk Nielsen, Aarhus University,
- Second opponent: Associate professor Inger-Lise Aamot Aksetøy, NTNU - Norwegian University of Science and Technology,
- Third member and chair of the evaluation committee: Professor II Mathias Toft, University of Oslo
Chair of the Defence
Professor emeritus Lars Engebretsen, University of Oslo
Principal Supervisor
Ingerid Kleffelgård, OUS - Oslo University Hospital
Summary
This thesis explores exercise intolerance in adults with persistent post concussion symptoms (PCS) after mild traumatic brain injury (mTBI), and evaluates sub symptom threshold aerobic exercise (SSTAE) guided by the Buffalo Concussion Treadmill Test (BCTT).
Exercise intolerance, defined by a heart rate–based symptom threshold, was highly prevalent (81%) among adults with persistent PCS referred to specialist care. Higher PCS symptom burden was associated with a greater likelihood of being exercise intolerant. In exploratory multivariable analyses, anxiety symptoms and resting heart rate were associated with exercise intolerance.
The feasibility study led to refinements of the randomized controlled trial (RCT) protocol, including reduced questionnaire burden and introduction of a 90% 〖"HR" 〗_max safety limit for both BCTT and training. In the RCT, patients with exercise intolerance were randomized to 12 weeks of SSTAE plus treatment-as-usual or to a control group receiving information and advice on physical activity within symptom limits plus treatment-as-usual.
The added benefit of SSTAE to treatment as usual did not lead to greater reduction in symptom burden compared to the control group. However, SSTAE significantly improved exercise intolerance and was safe and well tolerated. Both groups improved over time in symptom burden, health related quality of life, depression, anxiety, and fatigue.
Additional information
Contact the research support staff.