Maximal aerobic exercise and acute visual performance in females: Implications for concussion side-line testing

Many sports-related concussion (SRC) outcomes can be prevented by removing affected athletes and allowing return after full recovery. Diagnosing concussions on the side-line is challenging, as tools often rely on visual performance assessment. Since acute exercise can affect vision, it is vital to determine if exercise can mask potential brain injury if visual performance assessments are used. The aim of this study was to determine the effect of a single bout of maximal aerobic exercise on acute visual performance. Eighty previously sedentary females were randomly assigned to an experimental group (N = 40) or control group (N = 40) and completed an identical visual task test battery. Two weeks later, participants returned to participate in the test battery, with the experimental group doing so immediately following a maximal treadmill exercise protocol. Significant (P < 0.05) improvements were found in accommodation facility, saccadic eye movement, speed of recognition, peripheral awareness, and hand-eye coordination (P < 0.001 for all), but not in visual memory (P = 0.556). All visual tasks, barring visual memory, loaded onto a single factor and approximated the root mean square error of approximation (RMSEA) threshold value (RMSEA = 0.112 [90 %CI: 0.047–0.182]), and a significant large main effect was found on all factors as a universal visual task performance (P < 0.001; d = 1.01). This study shows that exercise can affect performance across multiple, but not all, visual tasks and should be utilised with caution in comprehensive side-line SRC assessments. Visual memory may be more stable to the effects of acute exercise and be considered for inclusion in side-line SRC assessments.