Exercise in the first week following concussion among collegiate athletes: Preliminary findings

Abstract

Objective: Our purpose was to examine the association between exercise after concussion with symptom severity, postural control, and time to symptom-resolution. Design: Longitudinal cohortMethods: Collegiate athletes (n=72; age=20.2±1.3 years; 46% female) with concussion completed a symptom questionnaire at initial (0.6±0.8 days post-injury) and follow-up (2.9±1.4 days post-injury) evaluations, and a postural control assessment at follow-up. Participants were grouped into those who exercised in between the time of injury and the follow-up evaluation and those who did not. Decisions regarding post-concussion exercise were made by a sports medicine team consisting of a single team physician and athletic trainers.Results: Thirteen athletes were not included in the current study, resulting in an 85% response rate. Thirteen of the athletes who completed the study exercised between evaluations (18%). There was no symptom resolution time difference between groups (median=13 [IQR=7-18] days vs. 13 [7-23] days; p= 0.83). Symptom ratings were similar between groups at the acute post-injury assessment vs. 17 [14-40]; p=0.21), but a main effect of group after adjusting for time from injury to assessment indicated the exercise group reported lower symptom severity than the no exercise group across both assessments (p=0.044). The dual-task gait speed of the exercise group was higher than the no exercise group (0.90±0.15 vs. 0.78±0.16 m/s; p=0.02).

Does Vestibular-Ocular-Motor (VOM) Impairment Affect Time to Return to Play, Symptom Severity, Neurocognition and Academic Ability in Student-Athletes following acute Concussion?

“…VOM function is required to complete academic activities (55), and the results of this study support this notion due to an association of greater academic impact in the presence of VOM impairment and academic time loss. One should also be aware these studies followed a different RTP protocol where physical exercise could resume after 48 hours if symptoms allowed, furthermore, resuming physical exercise has been associated with a quicker recovery (56). Future studies, with larger participant numbers may help to clarify if the use of VOMS at 4 days and after is able to determine if a student-athlete may have a delayed RTP.…”

“…This removes them from their usual sporting activities, which has been shown to be detrimental to health and wellbeing (58). VOM rehabilitation has shown promise in assisting recovery (59) and emerging data suggests resuming aerobic exercise within subsymptom threshold can enhance recovery (56,(60)(61)(62). There are currently no studies assessing the effect of early sub-symptom threshold exercise on VOM function recovery.…”

Postconcussion Exercise Volume Associations With Depression, Anxiety, and Dizziness Symptoms, and Postural Stability: Preliminary Findings

“…Furthermore, dual-task effects have been noted previously in relation to postconcussion exercise: those who began supervised exercise within the first week of a concussion performed better on a dual-task gait evaluation than those who did not begin exercising soon after injury. 32 Thus, given the potential of exercise to influence both cognitive and motor outcomes, dual-task evaluations may be useful to determine recovery in the context of exercise treatment programs following a concussion.…”

Pediatric Sports-Related Concussion: An Approach to Care

“…Studies have shown heart rate thresholds to be significantly lower in patients with prolonged recovery rates. 136,141 There is evidence that early controlled exercise does not adversely affect recovery, 137,[142][143][144] but the role and exact timing of exercise introduction in the acute management of SRC is still not completely understood. Recent studies have provided evidence that adolescent athletes who exercised within days of injury recovered significantly faster than those who did not exercise or were prescribed a stretching prescription.…”