Promoting Early Aerobic Exercise Initiation Post-Concussion: A pilot study examining how prescription method can influence recovery in a non-athlete, adult population. Results from the Toronto Concussion Study
Abstract
OBJECTIVE
Research on aerobic exercise (AEx) post-concussion has focused on athletes recovering from sport-related concussion. The goal of this pilot study was to examine the feasibility and preliminary efficacy of three AEx prescription methods in a general adult population.DESIGNThis pilot study involves three cohorts of participants, including a nested randomized component. Participants who were not in the nested randomized component were followed regularly by the clinic physician ("Usual Care" [UC]). Participants in the nested randomized component were randomly assigned to either "Exercise Testing (ET) + UC", or "Exercise Testing + Individualized Prescription (IP)". All randomized participants completed a Buffalo Concussion Treadmill Test (BCTT). ET + UC received usual care AEx recommendations, while ET + IP received an individualized prescription based on their BCTT performance.
RESULTS
75 participants were included in this analysis. There was an observed longer time to recovery of UC compared to ET (p = 0.046). There was no significant difference in time to recovery between ET + UC and ET + IP (p = 0.35).
CONCLUSION
Supervised initiation of AEx early after concussion appears to be feasible and improve outcomes compared to standard exercise recommendations. Individualized AEx prescription offered no additional recovery benefit in this sample; however, this finding is likely underpowered due to a small sample.
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 75 participants or records.
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