Exercise for Sport-Related Concussion and Persistent Postconcussive Symptoms.

Area of Science:

• Sports Medicine
• Neurology
• Rehabilitation

Background:

• Emerging research suggests aerobic exercise benefits sport-related concussion (SRC) and persistent postconcussive symptoms (PPCS).
• Current standard care often involves strict rest, contrasting with new findings on exercise efficacy.
• This review synthesizes literature on physical activity's role in SRC and PPCS management.

Purpose of the Study:

• To review existing literature on physical activity and prescribed exercise for SRC.
• To summarize evidence regarding exercise interventions for persistent postconcussive symptoms (PPCS).

Main Methods:

• Literature search of PubMed and Embase databases conducted in April 2019.
• Included studies assessing rest versus prescribed exercise for SRC and PPCS.
• Study design classified as a clinical review (Level 4 evidence).

Main Results:

• Most studies indicate spontaneous physical activity is safe post-SRC.
• Sub-symptom threshold aerobic exercise accelerates recovery from SRC and reduces PPCS.
• Graded exertion tests can assess exercise tolerance within days, offering diagnostic and prognostic insights.

Conclusions:

• Sub-symptom threshold aerobic exercise is a safe and effective treatment for SRC and PPCS.
• Further research is needed to optimize exercise protocols (method and dose) for SRC treatment.
• Investigating whether early exercise intervention can prevent PPCS is recommended.