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Open AccessFeature PaperCase Report

Daily Heart Rate Variability before and after Concussion in an American College Football Player

Georgia Southern University, Department of Health Sciences and Kinesiology, Biodynamics and Human Performance Center, 11935 Abercorn, St. Savannah, GA 31419, USA
Department of Kinesiology, Exercise Physiology Laboratory, University of Alabama, Tuscaloosa, AL 35487, USA
Graduate Athletic Training Program, University of Tennessee at Chattanooga, Chattanooga, TN 37403, USA
Department of Athletics, Sports Medicine, University of Alabama, Tuscaloosa, AL 35487, USA
Author to whom correspondence should be addressed.
Sports 2019, 7(5), 97;
Received: 21 March 2019 / Revised: 20 April 2019 / Accepted: 25 April 2019 / Published: 27 April 2019
(This article belongs to the Special Issue Monitoring Physiological Adaptation to Physical Training)
PDF [1026 KB, uploaded 27 April 2019]


This case report demonstrates the effects of sport-related concussion (SRC) on heart rate variability (HRV) in an American college football player. Daily measures of resting, ultra-short natural logarithm of the root mean square of successive differences (LnRMSSD), subjective wellbeing, and Player Load were obtained each training day throughout a 4-week spring camp and 4 weeks of preseason training. SRC occurred within the first 2 weeks of the preseason. During spring camp and preseason pre-SRC, the athlete demonstrated minimal day-to-day fluctuations in LnRMSSD, which increased post-SRC (LnRMSSD coefficient of variation pre-SRC ≤ 3.1%, post-SRC = 5.8%). Moderate decrements in daily-averaged LnRMSSD were observed post-SRC relative to pre-SRC (Effect Size ± 90% Confidence Interval = −1.12 ± 0.80), and the 7-day rolling average fell below the smallest worthwhile change for the remainder of the preseason. LnRMSSD responses to SRC appeared similar to trends associated with stress and training fatigue. Therefore, performance and sports medicine staff should maintain regular communication regarding player injury and fatigue status so that HRV can be interpreted in the appropriate context. Detection and monitoring of autonomic dysregulation post-SRC may require near-daily assessment, as LnRMSSD showed greater daily fluctuations rather than chronic suppression following the head injury. View Full-Text
Keywords: autonomic; cardiac-parasympathetic; traumatic brain injury; sports medicine; sports science autonomic; cardiac-parasympathetic; traumatic brain injury; sports medicine; sports science

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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MDPI and ACS Style

Flatt, A.A.; Wilkerson, G.B.; Allen, J.R.; Keith, C.M.; Esco, M.R. Daily Heart Rate Variability before and after Concussion in an American College Football Player. Sports 2019, 7, 97.

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