Acute Physical and Mental Activity Influence on Concussion Recovery

Abstract

Introduction: Physical activity (PA) and mental activity (MA) postconcussion has received renewed attention to improve concussion management; however, most protocols start after several days and do not assess the acute window. Therefore, the purpose of this study was to assess PA and MA in the first 48 h postconcussion on the time to symptom-free status and return to play. Methods: We recruited 78 NCAA Division I athletes (male, 51.3%; age, 19.6 ± 1.4 yr; height, 173.7 ± 11.5 cm; weight, 80.1 ± 23.2 kg) who were diagnosed with a sports-related concussion. Participants completed a 0-5 PA and MA scale daily until fully cleared for return to participation (mean, 15.1 ± 6.9 d). A quadratic model regression assessed PA and MA over the first 2 d (acute) postconcussion on to time to symptom-free status and return to play. Results: The overall model was significant for both time to symptom free (r 2 = 0.27, P = 0.004) and return to play (r 2 = 0.23, P = 0.019). Reported PA was the only significant predictor for time to symptom-free ( P = 0.002) and return-to-participation ( P = 0.006) day. Reported MA was not associated either outcome. Conclusions:The primary finding of this study was that mild to moderate PA acutely postconcussion was associated with reduced time to symptom free and return to participation as opposed to either lower or higher levels of PA. Conversely, acute MA was not associated with recovery outcomes. These results further elucidate the role of postconcussion PA.

More Physical Activity Is Correlated With Reduction in Kinesiophobia for Adolescents With Persistent Symptoms After Concussion

“…1 There is a growing body of evidence that early initiation of PA after concussion decreases recovery time, [8][9][10] and a recent study observed shorter symptom duration with PA initiation within the first 48 hours after concussion. 11 Building on this existing evidence, our results suggest an additional potential benefit of early PA in kinesiophobia reduction for those prone to persistent symptoms after concussion.…”

“…8 Recent research supports initiating physical activity (PA) early in recovery to decrease symptom duration and reduce the risk of developing persistent symptoms. [8][9][10][11] Current concussion consensus guidelines recommend an initial 24-to 48-hour period of rest followed by introduction of aerobic exercise as tolerated even while symptoms are still present. 1 However, there may be barriers to engaging in PA early after concussion, including self-limiting symptoms that reduce the propensity for exercise.…”

“…13 It is possible that a similar kinesiophobia and PA relationship exists after concussion, which is helpful to understand given the importance of PA for concussion recovery. [8][9][10][11] The relationship between PA and kinesiophobia during concussion recovery remains unexplored, yet examining this relationship may provide useful insight into another factor potentially affecting recovery trajectories. Due to the interdependence of kinesiophobia, PA, and time to concussion symptom resolution identified in previous research, 13,16,17 it is unknown how the continued presence of symptoms (ie, persistent symptoms after concussion) may influence the relationship between PA and kinesiophobia in the current study.…”

Comparison of Prescribed Physical Therapy to a Home Exercise Program for Pediatric Sports-Related Concussion Patients

“…Although every effort was made to instruct patients to complete HEPs as prescribed, as is the case with any at-home treatment program, it is not known how often and to what extent each patient completed their rehabilitation, limiting our ability to draw conclusions about a dose-response relationship. Additionally, although both groups were provided the same recommendations regarding aerobic physical exercise, it is possible that the HEP treatment group engaged in more physical activity than the PPT patients, which could have contributed to faster recovery [ 41 , 42 ]. Finally, generalizability is limited by a relatively homogenous sample related to race and ethnicity and due to the analytic sample receiving care within a specialty concussion clinic in a major metropolitan area with onsite access to PT and healthcare professionals trained in the management of SRC.…”

Latest Clinical Research Published by ACSM

“…Current guidelines recommend rest during the “acute phase” (first 24 to 48 h) of concussion recovery, and then gradually increasing activity if symptoms do not worsen. In the February 2022 issue of Medicine & Science in Sports & Exercise ® ( MSSE ), Buckley and colleagues (1) hypothesize that even within the first 48 h after concussion, moderate MA and PA that does not exacerbate symptoms may be beneficial. They conducted a prospective observational study of collegiate athletes who sustained a sports-related concussion (SRC).…”