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A Preliminary Study of the Effect of Early Aerobic Exercise Treatment for Sport-Related Concussion in Males

Leddy, John J. MD, FACSM, FACP*; Haider, Mohammad N. MD, PhD*,†; Hinds, Andrea L. PhD*; Darling, Scott MD*; Willer, Barry S. PhD

Clinical Journal of Sport Medicine: September 2019 - Volume 29 - Issue 5 - p 353–360
doi: 10.1097/JSM.0000000000000663
Original Research
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Objective: To study the effect of early prescribed aerobic exercise versus relative rest on rate of recovery in male adolescents acutely after sport-related concussion (SRC).

Design: Quasi-experimental design.

Setting: University sports medicine centers.

Participants: Exercise group (EG, n = 24, 15.13 ± 1.4 years, 4.75 ± 2.5 days from injury) and rest group (RG, n = 30, 15.33 ± 1.4 years, 4.50 ± 2.1 days from injury).

Interventions: Exercise group performed a progressive program of at least 20 minutes of daily subthreshold aerobic exercise. Rest group was prescribed relative rest (no structured exercise). Both groups completed daily online symptom reports (Postconcussion Symptom Scale) for 14 days.

Main Outcome Measures: Days to recovery after treatment prescription. Recovery was defined as return to baseline symptoms, exercise tolerant, and judged recovered by physician examination.

Results: Recovery time from initial visit was significantly shorter in EG (8.29 ± 3.9 days vs 23.93 ± 41.7 days, P = 0.048). Mixed-effects linear models showed that all symptom clusters decreased with time and that there was no significant interaction between treatment group and time. No EG participants experienced delayed recovery (>30 days), whereas 13% (4/30) of RG participants experienced delayed recovery.

Conclusions: These preliminary data suggest that early subthreshold aerobic exercise prescribed to symptomatic adolescent males within 1 week of SRC hastens recovery and has the potential to prevent delayed recovery.

*UBMD Orthopaedics and Sports Medicine, State University of New York at Buffalo, Buffalo, New York;

Departments of Neuroscience; and

Psychiatry, State University of New York at Buffalo, Buffalo, New York.

Corresponding Author: John J. Leddy, MD, FACSM, FACP, UBMD Orthopaedics and Sports Medicine, 160 Farber Hall, Buffalo, NY 14214 (leddy@buffalo.edu).

Research reported in this publication was supported by the National Institute of Neurological Disorders and Stroke of the National Institutes of Health under award number 1R01NS094444. Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under award number UL1TR001412 to the University at Buffalo. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

The authors report no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.cjsportmed.com).

Received March 05, 2018

Accepted July 25, 2018

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