Effect of Exercise Recommendation on Adolescents With Concussion

Abstract

We examined the effect of a noncontact, subsymptom exacerbation early exercise recommendation on recovery from sports-related concussion. Retrospective analysis of adolescents, 10-17 years old, with symptomatic concussion, within 30 days of injury was performed. Time to recovery was measured between the early exercise group and a comparison group. A total of 187 patients studied—112 in the exercise group and 75 in the comparison group; 55% were male (n = 103). The exercise group had a significantly longer duration of concussion symptoms (18.5 days vs 14, P = .002), although both groups recovered within the expected time to recovery for concussion. When analyzed separately, males experienced longer time to recovery from injury (19 days vs 14, P = .003), than females, respectively (18 days vs 14.5, P = .18). Recommendation of early exercise resulted in significantly longer recovery from concussion in male adolescents but had no significant effect in female adolescents; both groups recovered within the expected time frame.

Acute evaluation of sport-related concussion and implications for the Sport Concussion Assessment Tool (SCAT6) for adults, adolescents and children: a systematic review

“…Ability to discriminate between concussed athletes and controls —Both computerised and paper-and-pencil cognitive tests differentiated athletes diagnosed with concussion from controls with medium to large effects during the first 24–48 hours post injury 36–42 Figure 4. depicts a forest plot of the acceptable and high-quality studies that compared overall SAC scores between acute concussed athletes and controls or baseline values.…”

Changes in Physician Recommendations for Early Physical Activity After Pediatric Concussion: A Retrospective Study

“…Further studies are needed to determine the outcomes of prescribing early PA, especially pertaining to patient adherence to PA recommendations and how an early introduction of PA may affect patient recovery given some studies have found contrasting results. 25 Symptom score at the time of initial visit was significantly associated with the level of PA recommendation, with higher symptom scores associated with decreased likelihood of recommending "light aerobic activity" or "noncontact PA." Symptom burden has often been cited as the most significant predictor for symptom recovery, emphasizing the importance of managing symptoms at the time of visit. 26 Recent studies support that a gradual return to physical activity could be safe and possibly help reduce the time to symptom resolution among pediatric patients who adhere to PA recommendations even if the patient is symptomatic.…”

“…Further studies are needed to determine the outcomes of prescribing early PA, especially pertaining to patient adherence to PA recommendations and how an early introduction of PA may affect patient recovery given some studies have found contrasting results. 25…”

Consensus statement: An evidence‐based review of exercise, rehabilitation, rest, and return to activity protocols for the treatment of concussion and mild traumatic brain injury

“…For acute concussion, evidence concerning exercise included 20 studies: 7 RCTs, 41,[53][54][55][56][57][58] 8 prospective comparative studies, 42,43,[59][60][61][62][63][64] and 5 retrospective comparative studies 50,[65][66][67][68] in children, adolescents, and/or adults. Most studies involved adolescents.…”