Higher physical activity levels 2 weeks after concussion lowers symptom burden in youth

Key takeaways:

• Higher volumes of MVPA 2 weeks after concussion reduced the odds of persisting symptoms by 48%.
• However, the researchers warned about overexercising and recommended a gradual approach.

Youth who accumulated a certain volume of moderate-to-vigorous physical activity in the first 2 weeks following a concussion had reduced odds for persisting symptoms, researchers found.

According to Andrée-Anne Ledoux, PhD, an assistant professor at the University of Ottawa, and colleagues, early engagement in physical activity after a concussion has been associated with faster recovery, reduced symptom burden 2 weeks after the injury and a lower risk for developing persisting symptoms.

“However, the optimal volume of daily physical activity for achieving recovery in the general pediatric population remains unclear,” they wrote in JAMA Network Open.

The researchers analyzed data from 267 Canadian children and adolescents (mean age, 12 years; 44.6% girls) who had suffered an acute concussion and participated in a randomized clinical trial.

Cumulative moderate-to-vigorous physical activity (cMVPA) had been measured with accelerometers worn by the youth on their waists for 24 hours a day for 13 days after injury.

In the current study, Ledoux and colleagues determined symptom burden at 1, 2 and 4 weeks after injury using Health and Behavior Inventory (HBI) scores.

They found that participants who had volumes of 259 minutes of cMVPA in the first week had lower HBI scores compared with those with 90 minutes of cMVPA (difference = 5.45; 95% CI, 7.67 to 3.24). Additionally, youth who had 565 minutes of cMVPA through the first 2 weeks had lower HBI scores vs. those who had 237 minutes of cMVPA (difference = 2.85; 95% CI, 4.74 to 0.97).

Overall, higher cMVPA volumes at 2 weeks after injury was associated with 48% (OR = 0.48; 95% CI, 0.24-0.94) reduced odds of persisting symptoms after concussion compared with lower cMVPA volumes.

Ledoux and colleagues noted that the results could not determine a casual association between cMVPA and symptom burden “and are potentially limited by reverse causation.”

They also pointed out that findings were not significant at 4 weeks after injury, and that exceeding 300 minutes in the first week did not result in lowered symptom burden “and might even result in increased symptoms.”

“In contrast to individuals who were avoiding physical activity, those who were overexercising might require a different clinical approach,” they wrote. “As outlined in concussion guidelines, patients should gradually resume physical activity as long as their symptoms remain tolerable. This gradual approach ensures a safe and effective return to physical activity while minimizing the risk of exacerbating symptoms.”