Exercise tolerance testing

Exercise is an important contributing factor to wellbeing and brain health and its benefits should always be considered when planning a strategy towards optimal brain function.  Essentially, exercise is a stress to the body, which when applied appropriately, has proven benefits towards energy levels, immune system resilience and metabolic enhancement.  More specifically, exercise can promote the release of growth hormone, opioids, brain-derived neurotrophic factor, and nitric oxide, as well as increasing insulin receptor sensitivity. 

When a brain is compromised for one reason or another, it may be that exercise in the right dose is helpful, but troublesome if applied incorrectly.  

It is possible that somebody with a concussion, for example, will have a reduced capacity to exercise due to the brain’s inability to absorb the byproducts of exercise – i.e free radicals and oxidative stress. 

The benefits of exercise will occur afterwards, if the exercise intensity is tolerated without negative consequence.  The higher the intensity of exercise, the more “potential” for benefits but also the more risk of causing a negative consequence.  The trick is getting the dosage JUST RIGHT!

Exercise tolerance testing is a way that you can find out what is the right intensity for you.  When assessed, you will be asked to start with slow exercise, and then gradually increase your intensity.  Assessments will take place throughout the exercise test which will later serve as guidelines towards the most appropriate exercise program.  

Heart rate variability 

Heart rate variability is not a test of balance, or eye or head motions, rather it is a test for the autonomic nervous system.  The ANS, which controls essential functions such as heart-rate, breathing, blood pressure, temperature, amongst countless other things, can be disrupted in the event of dizziness or brain injury.  The disrupted ANS can then be the cause for many ongoing issues, impairing the body’s natural ability to restore, rest and recover.  HRV, which measures the change in heart rate over a given time period, is essentially an insight or measurement of the state of the ANS. 

By measuring HRV, the assessor can better determine the state of the  nervous system to decide, for example, if the patient is fatigued, adapting to training loads or becoming overloaded.  By measuring HRV and putting this into the context of “how the person feels”, along with sleep quality, stress, exercise load, etc, it becomes clearer as to when to increase rehab challenges, versus when to rest and recover.