Objectives: Our purpose was to examine the association between exercise after concussion with symptom severity, postural control, and time to symptom-resolution.
Design: Longitudinal cohort.
Methods: Collegiate athletes (n = 72; age = 20.2 ± 1.3 years; 46% female) with concussion completed a symptom questionnaire at initial (0.6 ± 0.8 days post-injury) and follow-up (2.9 ± 1.4 days post-injury) evaluations, and a postural control assessment at follow-up. Participants were grouped into those who exercised in between the time of injury and the follow-up evaluation and those who did not. Decisions regarding post-concussion exercise were made by a sports medicine team consisting of a single team physician and athletic trainers.
Results: Thirteen athletes were not included in the current study, resulting in an 85% response rate. Thirteen of the athletes who completed the study exercised between evaluations (18%). There was no symptom resolution time difference between groups (median = 13 [IQR = 7-18] days vs. 13 [7-23] days; p = 0.83). Symptom ratings were similar between groups at the acute post-injury assessment (median PCSS = 18.5 [7.5-26] vs. 17 [14-40]; p = 0.21), but a main effect of group after adjusting for time from injury to assessment indicated the exercise group reported lower symptom severity than the no exercise group across both assessments (p = 0.044). The dual-task gait speed of the exercise group was higher than the no exercise group (0.90 ± 0.15 vs. 0.78 ± 0.16 m/s; p = 0.02).
Conclusions: Athletes who were recommended aerobic exercise after concussion did not have worse outcomes than those who were not. Exercise within the first week after concussion does not appear to be associated with detrimental clinical outcomes.
Keywords: Exercise; Mild traumatic brain injury; Postural balance; Treatment.
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