Sub-threshold aerobic exercise for sport-related concussion
Trial question
What is the effect of early subsymptom threshold aerobic exercise treatment in adolescents with sport-related concussion?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
47.0% female
53.0% male
N = 103
103 patients (48 female, 55 male).
Inclusion criteria: adolescent athletes aged 13-18 years presenting within 10 days of sport-related concussion.
Key exclusion criteria: evidence of focal neurological deficit; inability to exercise because of orthopedic injury, cervical spine injury, diabetes, or known heart disease; increased cardiac risk according to american college of sports medicine criteria; history of moderate-severe traumatic brain injury.
Interventions
N=52 aerobic exercise (prescription to exercise at 80% of their threshold HR for symptom exacerbation).
N=51 stretching exercise (prescription for daily stretching lasting approximately 20 minutes).
Primary outcome
Median recovery time
13 days
17 days
17.0 days
12.8 days
8.5 days
4.3 days
0.0 days
Aerobic
exercise
Stretching
exercise
Significant
decrease ▼
Significant decrease in median recovery time (13 days vs. 17 days; AD -4 days, 95% CI -7 to -1).
Secondary outcomes
No significant difference in delayed recovery since injury (4% vs. 14%; ARD -10, 95% CI -21.21 to 1.21).
No significant difference in daily symptom reporting (83.8% vs. 86.6%; RR 0.97, 95% CI -0.38 to 2.32).
Conclusion
In adolescent athletes aged 13-18 years presenting within 10 days of sport-related concussion, aerobic exercise was superior to stretching exercise with respect to median recovery time.
Reference
John J Leddy, Mohammad N Haider, Michael J Ellis et al. Early Subthreshold Aerobic Exercise for Sport-Related Concussion: A Randomized Clinical Trial. JAMA Pediatr. 2019 Apr 1;173(4):319-325.
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