Adolescent athletes who experience a sports-related concussion have fewer lingering symptoms after participating in a symptom-limited aerobic exercise program, according to new data.
Aerobic Exercise Reduces Concussion Symptoms
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Secondary#aerobicexerciseprograms#persistentsymptoms#sportsrelatedconcussion
In a study, “Aerobic Exercise for Sport-related Concussion: A Systematic Review and Meta-analysis,” published in the December 2020 issue of Medicine & Science in Sports & Exercise, the researchers conducted a systematic review on the benefits of aerobic exercise in this cohort.
About 25% of people with sport-related concussion have lingering symptoms. The 2016 Berlin consensus on sports-related concussion recommends symptoms-limited aerobic exercise as a rehabilitation option.
The recommendations, however, was based on a limited amount of data. This latest study digs deeper into these programs’ effectiveness.
The objective of this systematic review was to assess the effects of symptom-limited aerobic exercise programs compared with control interventions on symptom intensity in individuals with sports-related concussions. The researchers searched MEDLINE, EMBASE< CINHAL and EBM databases for relevant randomized clinical trials that included aerobic exercise programs as an intervention for sports-related concussion.
They then applied the risk of bias and Grading of Recommendations, Assessment, Development and Evaluation recommendation to the pooled studies for quantitative analysis. They also conducted a descriptive analysis.
Overall, 7 randomized controlled trials, which included 326 adolescents in total, were analyzed. The researchers found that symptom-limited aerobic exercise programs had a significant beneficial effect on the perception of symptoms (6 studies, 277 participants, low-quality evidence; pooled standard mean difference, -0.44; 95% CI, -0.68 to -0.19).
Three studies found that when the programs are started in the acute phase, they improve symptomatic recovery better than control interventions (moderate quality evidence; pooled standard mean differences, -0.43; 95% CI, -0.71 to -0.15).
The researchers wrote, “Symptom-limited aerobic exercise programs are beneficial in improving symptoms of adolescents after a sports-related concussion. Good-quality studies are needed to determine effects on adults and on other outcomes.”
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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