For Teens with Concussion, Moderate Aerobic Activity Can Shorten the Time to Recovery

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

Moderate aerobic activity after sports-related concussion hastens the time to recovery, according to a randomized trial in JAMA Pediatrics.

Roughly 100 adolescents who presented within 10 days of sports-related concussion and tolerated the Buffalo Concussion Treadmill Test were randomized to an aerobic exercise or control group. The aerobic exercise group used a stationary bike or treadmill while wearing a heart rate monitor for 20 minutes each day; the target heart rate was 80% of the rate achieved during symptom exacerbation on the treadmill test. The control group did stretching exercises daily.

The median time to physician-confirmed symptom resolution was significantly shorter in the exercise group than in the control group (13 vs. 17 days).

Dr. Louis Bell of NEJM Journal Watch Pediatrics and Adolescent Medicine commented, "This randomized clinical trial changes our thinking on sports-related concussion management and shows that early individualized aerobic exercise will improve the time to recovery."

And Dr. Jonathan Silver of NEJM Journal Watch Psychiatry offered his take: "This landmark study demonstrates that the Buffalo Concussion Treadmill Test has diagnostic, prognostic, and therapeutic implications in adolescents with concussion. Not only is an early evaluation of aerobic exercise tolerance safe, but the prescription of carefully monitored aerobic exercise is therapeutic. It is hoped these results will be used to stop the practice of 'cocooning' and telling patients to avoid activity until 'they feel better.'"