title: Symptom response following acute bouts of exercise in concussed and non-concussed individuals - a systematic narrative review.
abstract: BACKGROUND
  Athletes suspected of being concussed are frequently evaluated on the side-line for self-reported symptoms which guide subsequent management and return-to-play decisions. Concussion-like symptoms have been shown to be influenced by prior participation in physical activity; however, the potential contribution of acute exercise on symptoms is not well understood.
  
  
  OBJECTIVE
  The purpose of this study was to systematically review the literature in order to further understand the acute effects of exercise on documented self-reported symptoms in both concussed and non-concussed individuals.
  
  
  METHODS
  Systematic narrative review.
  
  
  METHODS
  Nine electronic databases were systematically searched using keywords and MeSH terms that included; self-reported symptoms, sports-related concussion, brain concussion, exercise and athletic injuries. In addition, an extensive search of the grey literature was conducted.
  
  
  RESULTS
  Of the 785 articles retrieved, only five met the inclusion criteria comprising a total of 295 concussed and non-concussed participants. In general, the mean symptom scores increased from pre-exercise to post-exercise levels immediately following acute bouts of exercise in both concussed and non-concussed individuals.
  
  
  CONCLUSIONS
  Although the symptom scores increased following exercise in both concussed and non-concussed participants, this increase was only maintained for a relatively short duration. Thus, the application to real world situation is still to be established.
authors.affiliation: Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, PO Box 56, Dunedin 9054, New Zealand. Electronic address: arun.balasundaram@otago.ac.nz.
authors.forename: Arun Prasad
authors.initials: AP
authors.lastname: Balasundaram
authors.forename: John S
authors.initials: JS
authors.lastname: Sullivan
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Schneiders
authors.forename: Josie
authors.initials: J
authors.lastname: Athens
mesh_terms: D001265:Athletic Injuries / Q000150:complications* / Q000175:diagnosis; D001924:Brain Concussion / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D015444:Exercise / Q000502:physiology*; D006801:Humans; D020127:Recovery of Function / Q000502:physiology*; D015599:Trauma Severity Indices
keywords: Brain concussion; Exercise; Scales/checklists; Self-reported symptoms