Article type: Research Article
Authors: Chrisman, Sara P.D.a; b; c; * | Whitlock, Kathryn B.a | Somers, Elissad | Burton, Monique S.e | Herring, Stanley A.f | Rowhani-Rahbar, Alig | Rivara, Frederick P.a; c
Affiliations:
[a]
Seattle Children’s Research Institute, Center for Child Health, Behavior and Development, Seattle, WA, USA
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[b] Adolescent Medicine, University of Washington, Seattle, WA, USA
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[c]
Harborview Injury Prevention and Research Center Seattle, WA, USA
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[d]
Department of Physical Therapy Seattle, Seattle Children’s Hospital, WA, USA
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[e]
Department of Pediatrics, Department of Orthopedics and Sports Medicine, Seattle Children’s Hospital, Seattle, WA, USA
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[f]
University of Washington, Sports, Spine and Orthopedic Health, Seattle, WA, USA
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[g]
Department of Epidemiology, University of Washington, Seattle, WA, USA
Correspondence:
[*]
Address for correspondence: Sara P.D. Chrisman, MD, MPH, PO. Box 5371, Mailstop: CW8-6, Seattle, WA 98145, USA. Tel.: +1 206 484 2133; Fax: +1 206 884 7801; E-mail: sara.chrisman@seattlechildrens.org.
Abstract: BACKGROUND: Prior studies suggest potential benefit using monitored aerobic exercise to treat youth with persistent concussion symptoms, but these studies have been small. OBJECTIVES: To explore the safety and potential benefits of a rehabilitative exercise intervention, the Sub-symptom Threshold Exercise Program (SSTEP), for treating youth with persistent concussion symptoms >1 month. METHODS: We conducted a retrospective cohort study of 83 youth who participated in SSTEP, completing trajectory analysis of concussion symptoms using the symptom subscale of the Sport Concussion Assessment Tool, version 2 (SCAT-2). RESULTS: The average age of patients was 14.9+/–2.3 years and 54% were female. Most concussions (76%) were due to sports, the majority from football and girls’ soccer, and 55% had a previous concussion. Comorbidity was not uncommon: 14% had history of ADHD and 16% history of depression and/or anxiety. Most patients improved following the intervention, and none reported worsening. Symptoms decreased exponentially following initiation of SSTEP, and trajectory did not differ by duration of symptoms at presentation (<6 weeks, 6–12 weeks, >12 weeks). CONCLUSIONS: Monitored exercise programs appear to be safe and potentially beneficial for youth with persistent concussive symptoms. Large-scale controlled studies are needed to examine efficacy, ideal timing and duration.
Keywords: Brain concussion, sport, child, adolescent, traumatic brain injury, exercise, treatment, prolonged concussion syndrome
DOI: 10.3233/NRE-161436
Journal: NeuroRehabilitation, vol. 40, no. 4, pp. 493-499, 2017
