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S. Vuu1, C. Barr1, M. Killington1, J. Garner1, M. van den Berg1
1Flinders University, College of Nursing and Health Sciences, Adelaide, Australia
Background: Rest has traditionally been prescribed as treatment for people with mild traumatic brain injury (mTBI), however, there is no consensus to the optimal rest period and activity restriction. Recent consensus statements and guidelines have reported that after a brief period of rest during the acute phase (24-48 hours after injury), people with mTBI should be encouraged to become more active while staying below their symptom exacerbation threshold.
Purpose: To determine the effect of physical exercise on post-concussion symptoms in people with mTBI.
Methods: A search of randomized controlled trials was conducted in CINAHL, Cochrane Library, EMBASE, MEDLINE, SportDiscus and Web of Science, from 2010 to May 2020. Studies were included if they described the effects of a physical exercise intervention study on post-concussion symptoms in people with mTBI. Study quality, intervention reporting, and confidence in review findings were assessed with CASP, TIDieR and GRADE respectively.
Results: Fifteen eligible studies were identified for inclusion. Study interventions broadly comprised two categories of physical exercise, i.e. aerobic (n=10) and vestibular (n=5). Eight studies reported on the effect of aerobic exercise with post-concussion symptoms as the primary outcome, of which four demonstrated favourable effects. A meta-analysis revealed this improvement was statistically significant compared to usual care and alternative interventions (-0.35, 95% CI: -0.68, -0.03, p=0.03). Only two studies using vestibular exercise reported on post-concussion symptoms as primary outcome and yielded mixed results.
Conclusion(s): This study showed that the use of aerobic exercise to improve post-concussion symptoms is supported by high-confidence evidence, yet there is limited evidence for the use of vestibular exercise to improve post-concussion symptoms in people with mTBI. Future studies should investigate the optimal exercise dosage.
Implications: This study will enhance our ability to prescribe exercise for people with post-concussion symptoms following a mTBI.
Funding, acknowledgements: This study was not funded.
Keywords: Brain Concussion, Exercise, Systematic Review
Topic: Neurology
Did this work require ethics approval? No
Institution: Flinders University
Committee: Flinders University
Reason: Systematic review
All authors, affiliations and abstracts have been published as submitted.
