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  • Early Physical Activity After Concussion May Reduce Risk of Persistent Symptoms, Researchers Say

    A Canadian study published in JAMA turns the current thinking on postconcussion physical activity on its head. According to researchers, early return to physical activity within 1 week of concussion may actually decrease the likelihood of persistent symptoms in the pediatric population.

    The prospective cohort study included 2,413 children and adolescents between the ages of 5 and 18 years. At 7 days and at 28 days postinjury, participants filled out questionnaires about their physical activity and rated their postconcussion symptoms using the Post-Concussion Symptom Inventory. Of the respondents, 30.5% rested for the first 7 days, and 69.5% participated in some sort of physical activity, including light aerobic exercise, sport-specific exercise, noncontact drills, full-contact practice, or full competition.

    According to researchers, those who participated in early physical activity had a significantly lower risk of persistent postconcussion symptoms (PPCS) at day 28. Only 28.7% of those patients were still experiencing PPCS, compared with 40.1% of those who rested.

    Among the patients who were experiencing symptoms only at day 7, the rate of PPCS was lower for those who participated in light aerobic activity, moderate activity, and full-contact activity, compared with those who rested.

    Existing concussion guidelines recommend a period of physical and cognitive rest, while some have found “limited” or “preliminary” evidence supporting return to moderate or graded physical activity to aid in recovery. This study takes a step forward in the direction of activity, though authors recommend randomized controlled trials to explore the subject more objectively.

    The JAMA article received attention from several media outlets including CNN.com, which interviewed study co-author Roger Zemek, MD. Zemek told CNN that that earlier physical activity could play a psychologically important role in recovery, but he warned that return to activity should be approached with caution.

    Still, Zemek told CNN, the findings make a case for the importance of physical activity in recovery. “I think there are many different ways in which exercise may be beneficial," Zemek said. "Exercise itself can be a great medicine."

    Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.

    Physical therapists are well-qualified to assess and treat concussions. Read more about our advocacy efforts toward safe concussion management, sign up for related courses, and visit MoveForwardPT.com to see what APTA tells consumers about the PTs’ role in concussion management.


    • I was disappointed in this article when the last paragraph had a phrase "sign up for related courses" and the only courses on concussion were dated 2014. I hope APTA will offer courses in the future.

      Posted by Kathryn Anne Weber on 1/12/2017 9:14 PM

    • CSM 2016 had multiple, up to date lectures on concussion and it appears that CSM 2017 does as well.

      Posted by Zach Sutton on 1/14/2017 9:01 AM

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