Exercise is better than rest for a concussion
Concussed teenagers recover faster if they are prescribed aerobic exercise such as running on the treadmill or using an exercise bike, a new study found.
On average they recovered four days quicker than teens doing just stretching exercises who took 17 days.
One in 20 (four percent) of the teens in the aerobic exercise group took longer than four weeks to recover. But the rate was higher for those in the stretching group: three in 20 of them (14 percent) took a month to recover.
There is no proven treatment for concussion, especially among adolescents, who typically take the longest to recover.
The findings by the University of Buffalo also directly contradict the conventional approach to concussion, which often consists of nearly total rest, eliminating most physical and mental activities, including schoolwork.
Delayed concussion recovery creates more difficulty with schoolwork, can lead to depression and puts additional demands on the health care system and its costs
Senior author Dr Barry Willer, a professor of psychiatry, said: ‘Until now, nothing else has been proven in any way effective for treating concussion
‘This is the best evidence so far for a treatment that works.
‘Telling a teenager to go home and basically do nothing is depressing
‘It can actually increase their physical and psychological symptoms, and we see that particularly among girls.
‘But with our approach, you’re saying, sure, you can return to school and you should start doing these exercises.
‘Their chins are up, mom and dad are happy and so is the student.’
First author Clinical Professor of orthopedics Dr John Leddy said: ‘This research provides the strongest evidence yet that a prescribed, individualized aerobic exercise program that keeps the heart rate below the point where symptoms worsen is the best way to treat concussion in adolescents.’
The study involving 103 teenagers aged 13 to 18 with nearly equal numbers of boys and girls in a randomized clinical trial of a treatment in the acute phase after a sport-related concussion.
All were seen within 10 days after sustaining a sport-related concussion at one of the UBMD Orthopaedics and Sports Medicine clinics in Western New York or at the Pan Am Clinic in Winnipeg.
Each child was given a treadmill test to see how much exercise they could sustain without exacerbating symptoms.
Exercises were then tailored to each child after 52 were assigned to the aerobic exercise group and 51 to a stretching group. All did 20 minutes a day.
Each also wore a heart monitor and reported compliance and daily symptoms online.
Those in the aerobic group either walked on a treadmill, rode a stationary bike, or walked either inside or out.
Aside from the prescribed exercise, patients were advised to refrain from contact sports, gym class or team practice.
They were given advice about getting schoolwork done and told to avoid excessive use of electronic devices, since that can also aggravate symptoms.
One surprising finding was that only two participants out of 52 (four percent) in the aerobic exercise group took longer than four weeks to recover compared to seven out of 51 (14 percent) in the stretching group.
This did not reach statistical significance, but the scientific literature suggests, by contrast, that between 15 and 25 percent of adolescents who do not receive any treatment will be symptomatic past four weeks.
Dr Willer said: ‘Reducing the number of concussed adolescents who have delayed recovery has major implications.’
Delayed recovery creates more difficulty with schoolwork, can lead to depression and puts additional demands on the health care system and its costs.
Future studies are planned top see if the treatment is also effective in adults with concussion.
The study was published in JAMA Pediatrics.