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

• Published in: Journal of the International Neuropsychological Society 2021-09, Vol.27 (8), p.790-804
• Main Authors: Snyder, Aliyah R., Greif, Sarah M., Clugston, James R., FitzGerald, David B., Yarrow, Joshua F., Babikian, Talin, Giza, Christopher C., Thompson, Floyd J., Bauer, Russell M.
• Format: Article
• Language: English
• Subjects: Aerobics; Brain research; Clinical trials; Cognition; Concussion; Exercise; Feasibility studies; Heart rate; Intervention; Pathophysiology; Patients; Physical fitness; Placebos; Regular Research; Scheduling; Special Section: Exercise and Clinical Outcomes; Traumatic brain injury; Young adults
• ISSN: 1355-6177; 1469-7661
• DOI: 10.1017/S1355617721000886

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.