Over 150 minutes of weekly aerobic exercise after concussion improves sleep

Key takeaways:

• Sleep quality was more improved in those who exercised over 150 minutes a week after a concussion.
• Clinicians could counsel their patients on the benefits of sleep and exercise in concussion recovery.

Over 150 minutes of aerobic exercise a week following a concussion improved sleep quality in adolescents, study results published in The Journal of Head Trauma Rehabilitation showed.

The data are also consistent with past research on the benefits of exercise after a concussion “but add new insights that aerobic exercise at a higher volume than previously documented also may lead to benefits beyond concussion symptoms,” David R. Howell, PhD, ATC, an associate professor in the department of orthopedics at the University of Colorado School of Medicine, told Healio.

Healio previously reported that younger patients who accumulated a certain amount of moderate-to-vigorous physical activity in the first 2 weeks after a concussion had reduced odds for persisting symptoms.

Concussions can induce sleep problems that can, in turn, lead to other adverse health outcomes like poor cognitive function, according to background information provided by Howell and colleagues.

They explained that understanding how physical activity effects sleep health during concussion recovery “may provide insights into how treatments may be tailored to improve concussion outcomes.”

In the prospective cohort study, the researchers assessed sleep quality — measured with the Pittsburgh Sleep Quality Index, or PSQI — among 36 children and adolescents aged 10 to 17 years around 8 days after a concussion.

Researchers evaluated participants’ activity using wrist-worn actigraphy and recorded their exercise over the next month before having a follow-up visit around 34 days after the concussion.

No specific recommendations for exercise or sleep were given to participants beyond what their physician recommended.

Among participants, 15 completed more than 150 minutes of aerobic exercise a week, whereas 21 completed 150 minutes or less a week.

Researchers reported no significant difference in the total amount of time from concussion to the resolution of symptoms between the two groups.

However, the researchers found that the group that exercised more than 150 minutes a week between the visits showed greater median PSQI rating improvements vs. those who exercised 150 minutes or less, “with a large effect size noted.”

Howell and colleagues could not determine cause and effect but suggested some potential mechanisms.

“Those who slept better may have felt more refreshed and able to exercise, or exercise may have allowed for a higher energy expenditure during the day, leading to increased drowsiness at night and better sleep,” they wrote.

According to Howell, he suspects that the results would be replicated in a larger sample size and among different kinds of patients with concussions.

However, it is still not clear if other types of exercise would produce similar outcomes.

"It is apparent that physical activity, in general, is better than complete rest after concussion,” Howell explained. “We are also understanding that the intensity of physical activity after concussion may also be associated with concussion-related outcomes. However, we have not yet investigated the role of other types of exercise beyond aerobic exercise.”

Ultimately, “at this point, we recognize the beneficial effects of post-concussion exercise at a level that does not worsen existing or create new symptoms during concussion recovery,” he added. “Both sleep and exercise seem to be key elements in understanding the best ways that we can advise patients for relatively simple lifestyle modification to help facilitate recovery after concussion.”