Accelerating Concussion Recovery: Unleashing the Healing Potential of Aerobic Exercise
Concussions, though often considered minor injuries, can have significant and lingering effects on both physical and cognitive function. Traditional approaches to concussion management have focused on rest and gradual return to activity. However, emerging research suggests that aerobic exercise may play a crucial role in accelerating recovery and improving outcomes for individuals recovering from concussions.
A groundbreaking study published in JAMA Pediatrics by Leddy et al. (2019) sheds light on the potential benefits of early subthreshold aerobic exercise in concussion recovery. The study challenges the notion of strict rest and demonstrates that carefully prescribed aerobic exercise may expedite the healing process without exacerbating symptoms.
Leddy and his colleagues conducted a randomized clinical trial involving adolescents and young adults with sport-related concussions. Participants were assigned to either an early aerobic exercise group or a placebo stretching group. The aerobic exercise regimen consisted of sub-threshold intensity exercise, carefully monitored to ensure it did not exacerbate concussion symptoms. Remarkably, the group that engaged in aerobic exercise showed faster resolution of symptoms and could return to normal activity four days sooner than the placebo group.
“the group that engaged in aerobic exercise showed faster resolution of symptoms and could return to normal activity four days sooner than the placebo group.”
So, what is it about aerobic exercise that makes it beneficial for concussion recovery? Aerobic exercise has been shown to increase cerebral blood flow, promote neuroplasticity, and enhance cognitive function. These physiological effects may help mitigate the neuroinflammatory response associated with concussions and facilitate the restoration of normal brain function.
Furthermore, aerobic exercise can positively affect mood, sleep quality, and overall well-being, which are often disrupted following a concussion. By improving mood and reducing symptoms of depression and anxiety, aerobic exercise may contribute to a more positive recovery experience for individuals recovering from concussions.
It's crucial to recognize that not all aerobic exercises are equally beneficial for concussion recovery. The intensity, duration, and type of exercise should be customized to match the individual's symptoms and tolerance levels precisely. In Leddy et al.'s study, they explore subthreshold aerobic exercise, which involves working out at an intensity below the threshold where symptoms worsen, ensuring a safe and gradual return to physical activity. This threshold is determined through formal exertion testing, with the Buffalo Concussion Treadmill Test or the Buffalo Concussion Bike Test being the main tests utilized. You can obtain your free copies of these tests here Buffalo Concussion Treadmill Test and Buffalo Concussion Bike Test. For further information on these tests, you can refer to the original articles linked below in the reference section. During the test, your heart rate will be monitored, and you will be asked to rate your symptom level and rating of perceived exertion (RPE) after each stage, using diagrams like those provided below.
In conclusion, the study by Leddy et al. (2019) highlights the potential of aerobic exercise as a therapeutic intervention in concussion recovery. By incorporating carefully prescribed aerobic exercise into concussion management protocols, healthcare providers can offer patients a safe and effective pathway to recovery. The research findings thus far underscore the importance of harnessing the healing power of aerobic exercise in concussion rehabilitation and it is currently recommended to start light aerobic exercise or Rx HR sub-symptom training under the guidance of a healthcare professional experienced in managing concussions after 24-48 hrs of relative rest.
Reference:
· Leddy, J. J., Mannix, R., Willer, B., Haider, M. N., Cordingley, D. M., Freitas, M. S., & Ellis, M. J. (2019). Early Subthreshold Aerobic Exercise for Sport-Related Concussion. JAMA Pediatrics, 14214, 4–10. https://doi.org/10.1001/jamapediatrics.2018.4397
· John Leddy, et. al. (2018). Exercise is Medicine for Concussion. Current Sports Medicine Reports, 17(8), 262–270. https://doi.org/10.1249/JSR.0000000000000505 LK - http://link.kib.ki.se/?sid=EMBASE&issn=15378918&id=doi:10.1249%2FJSR.0000000000000505&atitle=Exercise+is+Medicine+for+Concussion&stitle=Curr.+Sports+Med.+Rep.&title=Current+Sports+Medicine+Reports&volume=17&issue=8&spage=262&epage=270&aulast=Leddy&aufirst=John+J.&auinit=J.J.&aufull=Leddy+J.J.&coden=&isbn=&pages=262-270&date=2018&auinit1=J&auinitm=J.
· Leddy, J. J., & Wilier, B. (2013). Use of Graded Exercise Testing in Concussion and Return-to-Activity Management. Current Sports Medicine Reports, 12(6), 370–376. https://doi.org/10.1249/JSR.0000000000000008
· Patricios, J. S., Schneider, K. J., Dvorak, J., Ahmed, O. H., Blauwet, C., Cantu, R. C., Davis, G. A., Echemendia, R. J., Makdissi, M., McNamee, M., Broglio, S., Emery, C. A., Feddermann-Demont, N., Fuller, G. W., Giza, C. C., Guskiewicz, K. M., Hainline, B., Iverson, G. L., Kutcher, J. S., … Meeuwisse, W. (2023). Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport-Amsterdam, October 2022. British Journal of Sports Medicine, 57(11), 695–711. https://doi.org/10.1136/bjsports-2023-106898