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John Lady and his colleagues at UB have spent years studying how a concussion affects young athletes. Credits: Douglas Levere / University at Buffalo

A new study from the University at Buffalo, New York shows that teenagers can speed recovery from an exercise-related concussion and reduce the risk of prolonged recovery by doing aerobic exercise within 10 days of an injury.

Published September 30, Lancet Child & Adolcent Health, a randomized controlled trial conducted by researchers at the UB Concussion Clinic found that the team study was announced in JAMA Pediatrics in 2019.

New studies show for the first time that the symptom threshold is aerobic exercise – meaning exercise that doesn’t worsen symptoms – starting at 10 days, participants reduced their risk of persistent symptoms after a concussion by 48%.

“This study clearly shows that rigorous physical rest until symptoms resolve spontaneously are no longer an acceptable method of treating sport-related cerebral adolescents,” said Jacobs Medical School. John J. Lady, the first orthopedics author at the university, said. Director of the UB Concussion Management Clinic in UB Biomedicine and Biomedicine and UBMD Orthopedics and Sports Medicine.

Physical activity recipe

“Our results suggest that doctors not only allow subsymptomatic thresholds for physical activity immediately after a sports-related concussion, but also prescribe them to speed recovery and reduce the risk of delayed recovery. It shows that we have to take it into account, ”he said.

Teenagers are the most vulnerable age group to concussions and take the longest to recover.

The new discoveries are the result of extensive research by Leddy and his colleagues Barry S. Willer, Ph.D., professor of psychiatry at Jacobs School in UB, director of research at a concussion clinic, and senior author of the paper. Leddy and Willer spent years studying how a concussion affected them. Young athlete ..

Her internationally renowned study played an important role in developing guidelines that no longer require that athletes recovering from a concussion should be given complete rest.

They began this series of studies in 2000 after jointly developing guidelines for returning to play after a concussion at the International Olympic Games. Since this was a known post-concussion problem, they were keen to develop a safe and systematic assessment of exercise tolerance.

“We Are Like Patients Heart Disease Perform the prescribed exercises by setting a safe threshold at which the patient can exercise. We developed the Buffalo Concussion Treadmill Test by adopting the cardiac treadmill test to put stress on the brain rather than the heart. Since regular aerobic exercise has been shown to be good for brain health, the goal was to use asymptomatic threshold training to see if it would help restore a confused brain. “

Non-pharmacological, safe and effective

“As recent studies show, this approach is not pharmacological, safe and effective,” said Leddy, adding that no adverse events were reported.

The study included adolescents between the ages of 13 and 18 who had suffered a concussion while exercising. A total of 118 adolescents were enrolled, 61 received aerobic exercise treatment, and 57 received placebo treatment for stretching exercises that did not increase heart rate.

People in the aerobics group took a median of 14 days to recover from a concussion, while those in the stretching group took 19 days.

The current survey differs from the 2019 team survey in the following ways:

  • Two new websites have been added. This was done for participants who were treated in UB-related community sports medicine clinics and two hospital-related clinics. One of these is the Philadelphia Children’s Hospital (attached to the University of Pennsylvania) and the Boston Children’s Hospital (attached to the Harvard Medical School). We tend to see patients with more severe injuries.
  • Previous studies relied on participants reporting the amount and intensity of exercise themselves, but the current study provided all participants with a heart rate monitor to wear while exercising. Rice field. This enabled the researchers to confirm that the participants were actually following the doctor’s prescription for aerobic exercise.
  • This study used a different study design called “therapeutic intent” and included all participants, including those who dropped out of the study before the study was completed. This is an approach that makes it harder to get positive results, but it is more a reflection of a real-life concussion. Process.

With heart rate monitors in particular, UB researchers revealed clearer images of the aerobic exercise participants were doing at home.

“We found that participants were very excited to follow the prescription and those who followed the prescription or who exceeded the 20 minute exercise prescription per day should take the prescription. It was a much quicker recovery than those who disobeyed, ”said Willer. “This finding is important because delayed recovery can be quite costly for adolescents, including academic difficulties, the risk of depression, and poor quality of life.”

According to Leddy and Willer, there are several possible reasons this approach can be effective. This is tied to the physiological and neurological benefits that result from aerobic exercise such as: B. strengthening neuroplasticity (i.e. repairing neurons).

“The results of this second study provide much stronger evidence that the Buffalo Protocol is not only effective, but also effective for those undergoing treatment and for any adolescent athlete who experiences a concussion. I’m very excited to be doing that, ”said Willer. “It is important that the benefits of the prescribed aerobic exercises were perceived equally by both sexes.”

The UB study only focused on teenagers who were recovering from an exercise-related concussion. Other polls Concussion Such an approach can be effective in non-athletic settings, but it has been found not to work as quickly or effectively as it does in athletes. Aerobic exercise approaches work for adults, but they usually need to be combined with other treatments, according to Leddy.

“In contrast, these types of side symptoms aerobics approaches are often the only treatment needed by adolescent athletes. “

UB co-authors with Leddy and Willer are Mohammad N, Deputy Research Director at the UB Concussion Management Clinic. Haider, MD, Ph.D. And Adam Cunningham from UBMD Orthopedics and Sports Medicine.

Concussion: The “mandatory” aerobic exercise used by young athletes recovered faster

For more informations:
Lancet Child and Adolescent Health (2021). DOI: 10.1016 / S2352-4642 (21) 00267-4, www.thelancet.com/journals/lan… (21) 00267-4 / full text

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University of Buffalo

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Aerobic exercise after a sports-related concussion accelerates recovery in adolescent athletes