Please find the below write-ups and links in support of the current Concussion Protocol established at Rehab 2 Perform.
A recently published (2020) study from the University of Pittsburgh found that early clinical treatment post-concussion may significantly reduce the recovery time required following a concussion. Out of the 162 athletes studied, researchers found that athletes treated within the first week of injury recovered faster than athletes evaluated eight days to three weeks post-injury. For both groups, the length of time of recovery to non-symptomatic presentation and back to baseline levels was the same; thus, this study suggests that the longer a patient waits to seek care post-concussion, the longer the recovery duration for the athlete and the greater the likelihood for more missed school days, practices, and games.
View Study Here. Kontos AP, Jorgensen-Wagers K, Trbovich AM, et al. Association of Time Since Injury to the First Clinic Visit With Recovery Following Concussion. JAMA Neurol. Published online January 06, 2020. doi:10.1001/jamaneurol.2019.4552
A 2019 study by Leddy et al. found that sub-symptom threshold aerobic exercise treatment prescribed to patients with concussion symptoms during the first week after SRC speeds recovery and can reduce the incidence of delayed recovery. For this study, patients were divided into an aerobic exercise group and a stretching group kept at a low intensity level. Aerobic exercise safely improved recovery with SRC in comparison to the placebo-esque stretching group and is one of the first studies to show that a primary benefit of early subthreshold exercise treatment interventions is a reduced incidence of delayed recovery (>30 days).
View Study Here. Leddy JJ, Haider MN, Ellis MJ, et al. Early Subthreshold Aerobic Exercise for Sport-Related Concussion: A Randomized Clinical Trial. JAMA Pediatr. 2019;173(4):319–325. doi:10.1001/jamapediatrics.2018.4397
This is the current concussion treatment guidelines established in 2017 for recommendations on treatment in patients post-concussion. Outlines procedures immediately post-concussion, in weeks following concussion, return to learn and return to sport recommendations.
View Study Here. McCrory P, Meeuwisse W, Dvorak J, et al. Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016 British Journal of Sports Medicine 2017;51:838-847.
Exercise intolerance is a typical symptom post-concussion. This study examined the recent observational and experimental data and presents evidence that subthreshold aerobic exercise is an appropriate treatment for patients post-concussion. Examiners evaluated the Buffalo Concussion Treadmill Test (BCTT) and the Buffalo Concussion Bike Test (BCBT) to establish a specific heart rate dosage of exercise patients should work towards for safe recovery post-concussion. In addition to potentially speeding up recovery, working at these determined heart rates may reduce the incidence of persistent postconcussive symptoms.
This study examined the efficacy of recommending strict rest post-concussion in recovery and outcomes after discharge from the pediatric emergency department. Patients aged 11-22 years that presented to the ED 24 within 24 hours of a concussion were randomized to either strict rest for 5 days vs the now-established usual care of 1-2 days rest followed by stepwise return to activity. Researchers found that there was no clinically significant difference in neurocognitive or balance outcomes; however, the strict rest group reported more daily post-concussive symptoms and slower overall symptom resolution. Therefore, recommending strict rest post-concussion offers no additional benefit to recovery and may be detrimental to overall recovery.
View Study Here. Danny George Thomas, Jennifer N. Apps, Raymond G. Hoffmann, Michael McCrea, Thomas Hammeke. Benefits of Strict Rest After Acute Concussion: A Randomized Controlled Trial. Pediatrics Feb 2015, 135 (2) 213-223; DOI: 10.1542/peds.2014-0966