Promoting Early Aerobic Exercise Initiation After Concussion: A Pilot Study Examining How Prescription Method Can Influence Recovery in a Non-athlete, Adult Population. Results From the Toronto Concussion Study.

Abstract

Research on aerobic exercise 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 aerobic exercise prescription methods in a general adult population. This 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"). Participants in the nested randomized component were randomly assigned to either "exercise testing + usual care" or "exercise testing + individualized prescription." All randomized participants completed a Buffalo Concussion Treadmill Test. Exercise testing + usual care received usual care aerobic exercise recommendations, while exercise testing + individualized prescription received an individualized prescription based on their Buffalo Concussion Treadmill Test performance. Seventy-five participants were included in this analysis. There was an observed longer time to recovery of usual care compared to exercise testing ( P = 0.046). There was no significant difference in time to recovery between exercise testing + usual care and exercise testing + individualized prescription ( P = 0.35). Supervised initiation of aerobic exercise early after concussion appears to be feasible and improve outcomes compared to standard exercise recommendations. Individualized aerobic exercise prescription offered no additional recovery benefit in this sample; however, this finding is likely underpowered because of a small sample.