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. 2023 Mar;26(3):183-188.
doi: 10.1016/j.jsams.2023.02.001. Epub 2023 Feb 8.

Early physical activity after concussion is associated with sleep quality but not dizziness among adolescent athletes

Katherine L Smulligan  1 , Mathew J Wingerson  2 , Casey C Little  3 , Julie C Wilson  4 , David R Howell  5
Affiliations

Early physical activity after concussion is associated with sleep quality but not dizziness among adolescent athletes

Katherine L Smulligan et al. J Sci Med Sport. 2023 Mar.

Abstract

Objectives: To assess the association between early physical activity and post-concussion sleep quality, dizziness, and postural stability among adolescents with concussion compared to uninjured controls.

Design: Cross-sectional.

Methods: Adolescents ages 13-18 years assessed within 14 days post-concussion and uninjured controls. Those with concussion reported if they participated in physical activity between the concussion and assessment. Participants completed the Dizziness Handicap Inventory, Pittsburgh Sleep Quality Index, and single/dual-task tandem gait.

Results: We enrolled 34 participants with concussion (early physical activity: n = 10, age = 15.8 ± 1.6 years, 70% female; no physical activity: n = 24, age = 16.0 ± 1.3 years, 50% female) and 21 uninjured controls (age = 16.0 ± 1.8 years, 48% female). Compared to controls, the no physical activity group reported worse sleep quality (Pittsburgh Sleep Quality Index: 3.8 ± 2.7 vs 8.0 ± 4.9 points, p = 0.002) and single-task tandem gait time (13.7 ± 3.4 vs 21.2 ± 8.1 s, p = 0.0006), while the early physical activity group did not (Pittsburgh Sleep Quality Index: 3.8 ± 2.7 vs 5.8 ± 3.2 points, p = 0.38; single-task tandem gait: 13.7 ± 3.4 vs 19.0 ± 5.7 s, p = 0.08). Compared to controls, early/no physical activity groups reported worse dizziness (Dizziness Handicap Inventory: 2.0 ± 3.4 vs 22.9 ± 23.8 vs 27.4 ± 19.2 points, p < 0.0001). There were no significant between-group differences for dual-task tandem gait (24.1 ± 8.0 vs 24.8 ± 6.2 vs 26.6 ± 7.3 s, p = 0.57).

Conclusions: The no physical activity group reported worse sleep quality and slower single-task tandem gait than controls, while both groups reported similar sleep quality and tandem gait. Early physical activity may promote sleep quality and postural stability, or early physical activity may be a function of improved sleep and postural stability after concussion.

Keywords: Exercise; Pediatric; Rehabilitation; Sport; Traumatic brain injury.

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Conflict of interest statement

Declaration of interest statement Dr. Howell has received research support from the Eunice Kennedy Shriver National Institute of Child Health & Human Development (R03HD094560, R01HD108133), the National Institute of Neurological Disorders And Stroke (R01NS100952, R43NS108823), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (1R13AR080451), 59th Medical Wing Department of the Air Force, MINDSOURCE Brain Injury Network, the Tai Foundation, and the Colorado Clinical and Translational Sciences Institute (UL1 TR002535-05) and he serves on the Scientific/Medical Advisory Board of Synaptek, LLC.

Figures

Figure 1:
Figure 1:
Violin plot describing the distribution of self-reported and postural stability measures for control participants and those with concussion who did and did not report early physical activity participation: (A) Pittsburgh Sleep Quality Index, (B) Post-Concussion Symptom Inventory, (C) Dizziness Handicap Inventory, (D) single-task tandem gait time, and (E) dual-task tandem gait time. The shaded area represents the probability density of data at each outcome measurement, smoothed using a kernel density estimator.
See this image and copyright information in PMC

References

    1. Veliz P, McCabe SE, Eckner JT, et al. Prevalence of Concussion Among US Adolescents and Correlated Factors. JAMA 2017; 318(12):1180–1182. Doi: 10.1001/jama.2017.9087. - DOI - PMC - PubMed
    1. Lumba-Brown A, Yeates KO, Sarmiento K, et al. Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children. JAMA Pediatr 2018; 172(11):e182853. Doi: 10.1001/jamapediatrics.2018.2853. - DOI - PMC - PubMed
    1. Davis GA, Anderson V, Babl FE, et al. What is the difference in concussion management in children as compared with adults? A systematic review. Br J Sports Med 2017; 51(12):949–957. Doi: 10.1136/bjsports-2016-097415. - DOI - PubMed
    1. McCrory P, Meeuwisse WH, Aubry M, et al. Consensus Statement on Concussion in Sport: The 4th International Conference on Concussion in Sport, Zurich, November 2012. J Athl Train 2013; 48(4):554–575. Doi: 10.4085/1062-6050-48.4.05. - DOI - PMC - PubMed
    1. Buckley TA, Munkasy BA, Clouse BP. Acute Cognitive and Physical Rest May Not Improve Concussion Recovery Time. J Head Trauma Rehabil 2016; 31(4):233–241. Doi: 10.1097/HTR.0000000000000165. - DOI - PMC - PubMed