3 minute read
public interest in concussion has exploded over the space of a generation , together with a new understanding of how best to help patients recover. concussion patients were once prescribed rest in a dark room, but in recent years concussion management has literally come out of the dark.
this is in large part because of a research boom: the number of studies on this mild form of traumatic brain injury has multiplied by 15 times over the last 20 years . this spike is a sign that the relatively young field of concussion research is maturing into a deeper science. it has created new evidence to support an entirely new approach to treating concussion. a recent wave of research papers has turned old practices on their heads.
for many years, concussion management followed a rest-is-best approach.
the motivation for using rest as a concussion-management strategy was a desire to limit exposure to environments and activities that might lead to secondary concussions , which can have compounding, longer-lasting effects. avoiding secondary injury was prioritized over proactive recovery.
advertisement
in the past few years, scientists have started to study aerobic exercise (or cardio training) as a management strategy for concussion symptoms. this exercise-is-medicine approach is diametrically opposed to the rest-is-best status quo.
many studies have examined the effects of sub-maximal (low-to-moderate intensity) aerobic exercise on concussion symptoms. this research confirms the utility and safety of such exercise for managing concussion symptoms, which vary between individuals, but they are typically categorized as somatic (or physical), cognitive, emotional and sleep-related . they can be assessed using adult- and child-specific symptom scales.
an academic review that summarizes the findings of individual studies shows that exercise is indeed one of the most effective, evidence-informed strategies for managing concussion symptoms. beyond a brief period (24 to 48 hours) of rest after concussion, the science now suggests that exercise is more beneficial than rest.
advertisement
patients exercise under supervision until they experience an increase in symptoms ( which research shows is transient and not associated with poor long-term outcome ) or are unable to continue exercising. the heart rate at the point where the test is terminated is noted, and patients are then prescribed an exercise program involving five to six days of aerobic exercise at an intensity equivalent to 80 per cent of the maximum heart rate achieved during the test.
as a next step, scientists are hard at work trying to determine the exact mechanism by which such sub-maximal exercise improves concussion symptoms. a leading hypothesis is that the autonomic nervous system (which regulates involuntary physiological processes, such as heart rate and breathing) is disturbed following a concussion, with its two constituent sub-systems becoming “uncoupled.”
advertisement
this article is republished from the conversation under a creative commons license. read the original article.
