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Early Subthreshold Aerobic Exercise for Sport-Related Concussion: A Randomized Clinical Trial.

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Sub-symptom threshold aerobic exercise speeds recovery for adolescents with sport-related concussions (SRC). This early intervention may also reduce the incidence of delayed recovery from SRC.

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Area of Science:

  • Sports Medicine
  • Neurology
  • Rehabilitation

Background:

  • Sport-related concussion (SRC) is a prevalent public health issue in adolescent athletes.
  • Currently, no definitive effective treatment exists for SRC.
  • Early management strategies are crucial for optimal recovery and return to play.

Purpose of the Study:

  • To evaluate the efficacy of subsymptom threshold aerobic exercise compared to a placebo-like stretching program for adolescents in the acute recovery phase of SRC.
  • To determine if early aerobic exercise influences the duration and incidence of delayed recovery from SRC.

Main Methods:

  • A multicenter prospective randomized clinical trial involving 103 adolescent athletes (13-18 years) within 10 days of SRC.
  • Participants were randomized to either progressive subsymptom threshold aerobic exercise or a progressive placebo-like stretching regimen.
  • Recovery was defined as being asymptomatic, physician-confirmed, and return to normal exercise tolerance; delayed recovery was defined as lasting ≥30 days.

Main Results:

  • Adolescents in the aerobic exercise group recovered faster (median 13 days) than those in the stretching group (median 17 days) (P=.009).
  • The aerobic exercise group showed a trend towards a lower incidence of delayed recovery (4% vs 14%, P=.08).
  • No significant differences were observed in baseline characteristics between the groups.

Conclusions:

  • Individualized subsymptom threshold aerobic exercise, initiated within the first week after SRC, is effective in accelerating recovery for adolescents.
  • This early aerobic exercise intervention shows potential in reducing the occurrence of prolonged recovery from sport-related concussion.
  • Findings support the integration of tailored aerobic exercise into the acute management of adolescent concussions.