Randomized Controlled Trial

. 2021 Sep;27(8):790-804.

doi: 10.1017/S1355617721000886.

The Effect of Aerobic Exercise on Concussion Recovery: A Pilot Clinical Trial

Aliyah R Snyder^{1

2}, Sarah M Greif^{3

4}, James R Clugston⁵, David B FitzGerald^{6

7}, Joshua F Yarrow^{7

8}, Talin Babikian^{1

2

4}, Christopher C Giza^{2

9

10}, Floyd J Thompson^{7

11

12}, Russell M Bauer^{3

7}

Affiliations

¹ Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA.
² UCLA Steve Tisch BrainSPORT Program, University of California, Los Angeles, Los Angeles, CA, USA.
³ Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
⁴ Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA.
⁵ Department of Community Health and Family Medicine, University of Florida, Gainesville, FL, USA.
⁶ Department of Neurology, University of Florida, Gainesville, FL, USA.
⁷ Research Service and Brain Rehabilitation Research Center, Malcolm Randall VA Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA.
⁸ Division of Endocrinology, Diabetes, and Metabolism, University of Florida College of Medicine, Gainesville, FL, USA.
⁹ Mattel Children's Hospital, University of California, Los Angeles, Los Angeles, CA, USA.
¹⁰ Department of Pediatrics, University of California, Los Angeles, Los Angeles, CA, USA.
¹¹ Department of Physiological Sciences, University of Florida, Gainesville, FL, USA.
¹² Department of Neuroscience, University of Florida, Gainesville, FL, USA.

PMID: 34548116
PMCID: PMC8601125
DOI: 10.1017/S1355617721000886

Randomized Controlled Trial

The Effect of Aerobic Exercise on Concussion Recovery: A Pilot Clinical Trial

Aliyah R Snyder et al. J Int Neuropsychol Soc. 2021 Sep.

. 2021 Sep;27(8):790-804.

doi: 10.1017/S1355617721000886.

Authors

Affiliations

¹ Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA.
² UCLA Steve Tisch BrainSPORT Program, University of California, Los Angeles, Los Angeles, CA, USA.
³ Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
⁴ Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA.
⁵ Department of Community Health and Family Medicine, University of Florida, Gainesville, FL, USA.
⁶ Department of Neurology, University of Florida, Gainesville, FL, USA.
⁷ Research Service and Brain Rehabilitation Research Center, Malcolm Randall VA Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA.
⁸ Division of Endocrinology, Diabetes, and Metabolism, University of Florida College of Medicine, Gainesville, FL, USA.
⁹ Mattel Children's Hospital, University of California, Los Angeles, Los Angeles, CA, USA.
¹⁰ Department of Pediatrics, University of California, Los Angeles, Los Angeles, CA, USA.
¹¹ Department of Physiological Sciences, University of Florida, Gainesville, FL, USA.
¹² Department of Neuroscience, University of Florida, Gainesville, FL, USA.

PMID: 34548116
PMCID: PMC8601125
DOI: 10.1017/S1355617721000886

Abstract

Objective: The purpose of this study was to pilot safety and tolerability of a 1-week aerobic exercise program during the post-acute phase of concussion (14-25 days post-injury) by examining adherence, symptom response, and key functional outcomes (e.g., cognition, mood, sleep, postural stability, and neurocognitive performance) in young adults.

Method: A randomized, non-blinded pilot clinical trial was performed to compare the effects of aerobic versus non-aerobic exercise (placebo) in concussion patients. The study enrolled three groups: 1) patients with concussion/mild traumatic brain injury (mTBI) randomized to an aerobic exercise intervention performed daily for 1-week, 2) patients with concussion/mTBI randomized to a non-aerobic (stretching and calisthenics) exercise program performed daily for 1-week, and 3) non-injured, no intervention reference group.

Results: Mixed-model analysis of variance results indicated a significant decrease in symptom severity scores from pre- to post-intervention (mean difference = -7.44, 95% CI [-12.37, -2.20]) for both concussion groups. However, the pre- to post-change was not different between groups. Secondary outcomes all showed improvements by post-intervention, but no differences in trajectory between the groups. By three months post-injury, all outcomes in the concussion groups were within ranges of the non-injured reference group.

Conclusions: Results from this study indicate that the feasibility and tolerability of administering aerobic exercise via stationary cycling in the post-acute time frame following post-concussion (14-25 days) period are tentatively favorable. Aerobic exercise does not appear to negatively impact recovery trajectories of neurobehavioral outcomes; however, tolerability may be poorer for patients with high symptom burden.

Keywords: Brain Injuries; Feasibility Studies; Neuropsychology; Public Health; Return to Sport; Sports.

PubMed Disclaimer

Conflict of interest statement

CONFLICTS OF INTEREST

None.

Figures

**Figure 2.**
CONSORT enrollment and allocation flow diagram.

**Figure 3.**
Symptom severity ratings by group across study visits and the seven-day intervention. *Note.* Error bars represent standard error of the mean

**Figure 4.**
Pre-exercise symptoms severity ratings across the 7-day intervention period by groups. *Note.* Error bars represent standard error of the mean

See this image and copyright information in PMC

References

1. Albanes D, Conway JM, Taylor PR, Moe PW, & Judd J (1990). Validation and comparison of eight physical activity questionnaires. Epidemiology. 10.1097/00001648-199001000-00014 - DOI - PubMed
1. Allen RP, Kosinski M, Hill-Zabala CE, & Calloway MO (2009). Psychometric evaluation and tests of validity of the Medical Outcomes Study 12-item Sleep Scale (MOS sleep). Sleep Medicine. 10(5), 531–539. 10.1016/j.sleep.2008.06.003 - DOI - PubMed
1. Asken BM, Bauer RM, Guskiewicz KM, McCrea MA, Schmidt JD, Giza CC, : : : Svoboda S (2018). Immediate removal from activity after sport-related concussion is associated with shorter clinical recovery and less severe symptoms in collegiate student-athletes. American Journal of Sports Medicine, 46(6), 1465–1474. 10.1177/0363546518757984 - DOI - PMC - PubMed
1. Asken BM, McCrea MA, Clugston JR, Snyder AR, Houck ZM, & Bauer RM (2016). Playing through it: Delayed reporting and removal from athletic activity after concussion predicts prolonged recovery. Journal of Athletic Training, 51(4), 329–335. 10.4085/1062-6050-51.5.02 - DOI - PMC - PubMed
1. Beck AT, Steer RA, & Brown GK (1996). Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation.

Publication types

Actions
Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
Medical
- ClinicalTrials.gov
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

The Effect of Aerobic Exercise on Concussion Recovery: A Pilot Clinical Trial

Affiliations

The Effect of Aerobic Exercise on Concussion Recovery: A Pilot Clinical Trial

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical