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The acute, systemic effects of aerobic exercise in recently concussed adolescent student-athletes: preliminary findings

Abstract

Objectives

Examine the acute effects (pre-, during, post-intervention) of two different intensities of aerobic exercise or rest on autonomic, oculomotor, and vestibular function and symptom burden in patients with a recent sport-related concussion (SRC) and compare their responses to sex-matched, age-stratified, non-concussed (HEALTHY) student-athletes.

Methods

Student-athletes between the ages of 13 and 18 that presented to the sports medicine clinic within Day 3–7 post-SRC and from local schools were recruited for a randomized controlled trial (RCT). The participants were administered the Vestibular/Ocular Motor Screening (VOMS), King-Devick (K-D), and Post-Concussion Symptom Scale (PCSS) before and after the intervention. Heart rate variability (HRV) and mean arterial pressure (MAP) were collected before, during, and after the intervention. The intervention was either a single, 20-min session of treadmill walking at 40% (40HR) or 60% of age-predicted max heart rate (60HR), or seated, rest (NOEX).

Results

30 participants completed the intervention with the SRC group treated 4.5 ± 1.3 days post-injury. Pre-exercise HRV and MAP were significantly different (p’s < 0.001) during treatment but returned to pre-exercise values within 5 min of recovery in both the SRC and HEALTHY groups. Both the SRC and HEALTHY groups exhibited similar reductions pre- to post-intervention for symptom severity and count (p’s < 0.05), three VOMS items (p’s < 0.05) but not K-D time.

Conclusions

To date, this is the first adolescent RCT to report the acute, systemic effects of aerobic exercise on recently concussed adolescent athletes. The interventions appeared safe in SRC participants, were well-tolerated, and provided brief therapeutic benefit.

Trial registration

Clinicaltrials.gov Identifier NCT03575455.

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Availability of data and materials

Data from the study can be made available upon request to the editorial board if there are any questions about data integrity or clarifications needed.

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Acknowledgements

The authors would like to acknowledge the contributions of: the clinical team for study execution (Drs. Scott Burkhart, Daniel Petty, Scott Porter, and Todd Hewitt and Tallahassee Orthopedic Clinic); the scientific advisors for study development (Drs. Lynn Panton, Michael Ormsbee, and Cathy Levenson); and the athletic trainers for assistance with coordination of recruitment (Alan Morales, Jordan Bush, and Kaydi Blackstock).

Funding

The publication was made possible in part with support from Tallahassee Orthopedic Clinic and funded by Tallahassee Orthopedic Clinic Foundation.

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Contributions

PRW was responsible for study conceptualization, design, coordination, and data collection and prepared and edited the article and supplemental file. JRM was responsible for data analysis and prepared and edited the article and supplemental file. SOB was responsible for study conceptualization, design, coordination and prepared and edited the article. MASG was responsible for study design, data analysis and edited the article. J-SK was responsible for study conceptualization, design, coordination, and edited the article.

Corresponding author

Correspondence to P. R. Worts.

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Conflict of interest

Phillip Worts and Scott Burkhart are co-authors of the Frequency of Concussion Symptoms (FOCS) survey. Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by Tallahassee Orthopedic Clinic or Tallahassee Orthopedic Clinic Foundation. The remaining authors have no conflicts.

Ethics approval

The Florida State University Institutional Review Board approved this study.

Consent to participate

Adult-age participants provided consent after a review of study methods and questions answered. For minors, parents/guardians provided permission, and minors provided assent after a review of study methods and questions answered.

Additional information

Communicated by Ellen Adele Dawson.

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Worts, P.R., Mason, J.R., Burkhart, S.O. et al. The acute, systemic effects of aerobic exercise in recently concussed adolescent student-athletes: preliminary findings. Eur J Appl Physiol 122, 1441–1457 (2022). https://doi.org/10.1007/s00421-022-04932-4

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Keywords

  • Pediatrics
  • Mild traumatic brain injury
  • mTBI
  • Physical activity
  • Active rehabilitation
  • Exertion