Research Reports - Aerobic exercise for adolescents with prolonged symptoms after mild traumatic brain injury

J Head Trauma Rehabil. 2016 Apr 26. [Epub ahead of print]

Kurowski BG(1), Hugentobler J, Quatman-Yates C, Taylor J, Gubanich PJ, Altaye M,
Wade SL.

OBJECTIVE: To describe the methodology and report primary outcomes of an
exploratory randomized clinical trial (RCT) of aerobic training for management of
prolonged symptoms after a mild traumatic brain injury (mTBI) in adolescents.
SETTING: Outpatient research setting.
PARTICIPANTS: Thirty adolescents between the ages of 12 and 17 years who
sustained a mTBI and had between 4 and 16 weeks of persistent symptoms.
DESIGN: Partially blinded, pilot RCT of subsymptom exacerbation aerobic training
compared with a full-body stretching program.
MAIN MEASURES: The primary outcome was postinjury symptom improvement assessed by
the adolescent's self-reported Post-Concussion Symptom Inventory (PCSI) repeated
for at least 6 weeks of the intervention. Parent-reported PCSI and adherence are
also described.
RESULTS: Twenty-two percent of eligible participants enrolled in the trial.
Repeated-measures analysis of variance via mixed-models analysis demonstrated a
significant group × time interaction with self-reported PCSI ratings, indicating
a greater rate of improvement in the subsymptom exacerbation aerobic training
group than in the full-body stretching group (F = 4.11, P = .044). Adherence to
the home exercise programs was lower in the subsymptom exacerbation aerobic
training group compared with the full-body stretching group (mean [SD] times per
week = 4.42 [1.95] vs 5.85 [1.37], P < .0001) over the duration of the study.
CONCLUSION: Findings from this exploratory RCT suggest subsymptom exacerbation
aerobic training is potentially beneficial for adolescents with persistent
symptoms after an mTBI. These findings and other recent research support the
potential benefit of active rehabilitation programs for adolescents with
persistent symptoms after an mTBI. Larger replication studies are needed to
verify findings and improve generalizability. Future work should focus on
determining the optimal type, timing, and intensity of active rehabilitation
programs and characteristics of individuals most likely to benefit. 

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