Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Feb 5;20(1):46.
doi: 10.1186/s12883-020-1622-x.

Improving symptom burden in adults with persistent post-concussive symptoms: a randomized aerobic exercise trial protocol

Leah J Mercier  1 , Tak S Fung  2 , Ashley D Harris  3 , Sean P Dukelow  4 , Chantel T Debert  4
Affiliations

Improving symptom burden in adults with persistent post-concussive symptoms: a randomized aerobic exercise trial protocol

Leah J Mercier et al. BMC Neurol. .

Abstract

Background: Persistent post-concussive symptoms (PPCS) affect up to 30% of individuals following mild traumatic brain injury. PPCS frequently includes exercise intolerance. Sub-symptom threshold aerobic exercise has been proposed as a treatment option for symptom burden and exercise intolerance in this population. The primary aim of this study is to evaluate whether a progressive, sub-symptom threshold aerobic exercise program can alleviate symptom burden in adults with PPCS.

Methods: Fifty-six adults (18-65) with PPCS (>3mos-5 yrs) will be randomized into two groups: an immediate start 12-week aerobic exercise protocol (AEP) or delayed start 6-week placebo-like stretching protocol (SP), followed by AEP. Aerobic or stretching activities will be completed 5x/week for 30 mins during the intervention. Online daily activity logs will be submitted. Exercise prescriptions for the AEP will be 70-80% of heart rate at the point of symptom exacerbation achieved on a treadmill test with heart rate monitoring. Exercise prescription will be updated every 3-weeks with a repeat treadmill test. The Rivermead Post-concussion Symptom Questionnaire will be the primary outcome measure at 6 and 12-weeks of intervention. Secondary outcomes include assessments of specific symptoms (headache, quality of life, mood, anxiety, fatigue, dizziness, sleep parameters, daytime sleepiness) in addition to blood biomarkers and magnetic resonance imaging and spectroscopy data for quantification of brain metabolites including γ-aminobutyric acid (GABA), glutathione, glutamate and N-acetyl aspartate (NAA) all measured at 6 and 12-weeks of intervention.

Discussion: This trial will evaluate the use of aerobic exercise as an intervention for adults with PPCS, thus expanding our knowledge of this treatment option previously studied predominantly for adolescent sport-related concussion.

Trial registration: ClinicalTrials.gov - NCT03895450 (registered 2019-Feb-11).

Keywords: Aerobic exercise; Concussion; Exercise intolerance; Mild traumatic brain injury; Persistent post-concussive symptoms; Post-concussion syndrome; Quality of life; Randomized controlled trial.

PubMed Disclaimer

Conflict of interest statement

The authors declare they have no competing interests.

Figures

Fig. 1
Fig. 1
Study Design Protocol
See this image and copyright information in PMC

References

    1. Giza CC, Hovda DA. The new neurometabolic cascade of concussion. Neurosurgery. 2014;75(Suppl 4):S24–S33. doi: 10.1227/NEU.0000000000000505. - DOI - PMC - PubMed
    1. Korley FK, Kelen GD, Jones CM, Diaz-Arrastia R. Emergency department evaluation of traumatic brain injury in the United States, 2009-2010. J Head Trauma Rehabil. 2016;31(6):379–387. doi: 10.1097/HTR.0000000000000187. - DOI - PMC - PubMed
    1. McCrory P, Meeuwisse W, Dvorak J, Aubry M, Bailes J, Broglio S, et al. Consensus statement on concussion in sport-the 5(th) international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med. 2017;51(11):838–847. - PubMed
    1. Ahman S, Saveman BI, Styrke J, Bjornstig U, Stalnacke BM. Long-term follow-up of patients with mild traumatic brain injury: a mixed-method study. J Rehabil Med. 2013;45(8):758–764. doi: 10.2340/16501977-1182. - DOI - PubMed
    1. Theadom A, Parag V, Dowell T, McPherson K, Starkey N, Barker-Collo S, et al. Persistent problems 1 year after mild traumatic brain injury: a longitudinal population study in New Zealand. Br J Gen Pract. 2016;66(642):e16–e23. doi: 10.3399/bjgp16X683161. - DOI - PMC - PubMed

Publication types

Associated data