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Graded Combined Aerobic Resistance Exercise (CARE) to Prevent or Treat the Persistent Post-concussion Syndrome

  • Neurotrauma (D. Sandsmark, Section Editor)
  • Published:
Current Neurology and Neuroscience Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To review the growing body of indirect and direct evidence that suggests that exercise can be helpful for children, adolescents, and adults with persistent symptoms following a mild traumatic brain injury (mTBI).

Recent Findings

The direct evidence shows that graded exercise assessments are safe, and that aerobic exercise interventions are associated with improvement of multiple symptoms and other benefits, including earlier return-to-sport. The indirect evidence supports this approach via studies that reveal the potential mechanisms, and show benefits for related presentations and individual symptoms, including headaches, neck pain, vestibular problems, sleep, stress, anxiety, and depression. We document the forms of exercise used for the post-acute management of mTBI, highlight the knowledge gaps, and provide future research directions.

Summary

We recommend trialing a new approach that utilizes a graduated program of individually prescribed combined aerobic resistance exercises (CARE) if mTBI symptoms persist. This program has the potential to improve patient outcomes and add to the management options for providers.

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Funding

This publication was produced without a direct external funding source. Further development of the exercise program is supported by a research grant from the Royal Brisbane and Women’s Hospital Foundation and the Queensland University of Technology. Grant Iverson acknowledges unrestricted philanthropic support from the Mooney-Reed Charitable Foundation.

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Authors and Affiliations

  1. School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia

    Karen A. Sullivan

  2. Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia

    Karen A. Sullivan

  3. O Block B Wing, Kelvin Grove Campus, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland, 4059, Australia

    Karen A. Sullivan

  4. College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia

    Andrew P. Hills

  5. Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, 02115, USA

    Grant L. Iverson

  6. Spaulding Rehabilitation Hospital, Boston, MA, USA

    Grant L. Iverson

  7. MassGeneral Hospital for Children™ Sport Concussion Program, Boston, MA, 02114, USA

    Grant L. Iverson

  8. Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Boston, MA, USA

    Grant L. Iverson

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  1. Karen A. Sullivan
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Correspondence to Karen A. Sullivan.

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Conflict of Interest

Karen Sullivan and Andrew Hills each declare no potential conflicts of interest. Grant Iverson has a clinical and consulting practice in forensic neuropsychology involving individuals who have sustained mild TBIs. He has received research funding from several test publishing companies, including ImPACT Applications, Inc., CNS Vital Signs, and Psychological Assessment Resources (PAR, Inc.). He has received salary support from the Harvard Integrated Program to Protect and Improve the Health of National Football League Players Association Members. He acknowledges unrestricted philanthropic support from the Mooney-Reed Charitable Foundation and ImPACT Applications, Inc.

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Sullivan, K.A., Hills, A.P. & Iverson, G.L. Graded Combined Aerobic Resistance Exercise (CARE) to Prevent or Treat the Persistent Post-concussion Syndrome. Curr Neurol Neurosci Rep 18, 75 (2018). https://doi.org/10.1007/s11910-018-0884-9

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