A Preliminary Study of the Effect of Early Aerobic Exercise Treatment for Sport-Related Concussion in Males

Objective: To study the effect of early prescribed aerobic exercise versus relative rest on rate of recovery in male adolescents acutely after sport-related concussion (SRC). Design: Quasi-experimental design. Setting: University sports medicine centers. Participants: Exercise group (EG, n = 24, 15.13 +/- 1.4 years, 4.75 +/- 2.5 days from injury) and rest group (RG, n = 30, 15.33 +/- 1.4 years, 4.50 +/- 2.1 days from injury). Interventions: Exercise group performed a progressive program of at least 20 minutes of daily subthreshold aerobic exercise. Rest group was prescribed relative rest (no structured exercise). Both groups completed daily online symptom reports (Postconcussion Symptom Scale) for 14 days. Main Outcome Measures: Days to recovery after treatment prescription. Recovery was defined as return to baseline symptoms, exercise tolerant, and judged recovered by physician examination. Results: Recovery time from initial visit was significantly shorter in EG (8.29 +/- 3.9 days vs 23.93 +/- 41.7 days, P = 0.048). Mixed-effects linear models showed that all symptom clusters decreased with time and that there was no significant interaction between treatment group and time. No EG participants experienced delayed recovery (>30 days), whereas 13% (4/30) of RG participants experienced delayed recovery. Conclusions: These preliminary data suggest that early subthreshold aerobic exercise prescribed to symptomatic adolescent males within 1 week of SRC hastens recovery and has the potential to prevent delayed recovery.