A pilot study of active rehabilitation for adolescents who are slow to recover from sport-related concussion.
The purpose of this study was to examine the effectiveness of an active rehabilitation intervention for adolescents who are slow-to-recover after a sport-related concussion. Ten adolescents (three girls and seven boys) seen at the Montreal Children's Hospital Concussion Clinic participated in this case series. Adolescents who were symptomatic more than 4 weeks after the injury were provided with an active rehabilitation intervention (M = 7.9 weeks following injury; range = 3.7 to 26.2 weeks). The rehabilitation program includes gradual, closely monitored light aerobic exercise, general coordination exercises, mental imagery, as well as reassurance, normalization of recovery, and stress/anxiety reduction strategies. The program continued until complete symptom resolution and readiness to begin stepwise return to activities. The primary outcome of the study was evolution of post-concussion symptoms. Secondary outcomes included mood, energy, balance, and cognition. After the intervention, post-concussion symptoms significantly decreased for the group of participants. They also had decreased fatigue and improved mood after 6 weeks of initiating the rehabilitation intervention. This case series shows that postconcussive symptoms and functioning in adolescents following sports-related concussion can be improved after participation in an active rehabilitation intervention. The introduction of graded light intensity exercise in the post-acute period following concussion is safe, feasible and appears to have a positive impact on adolescents' functioning.
School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.|Trauma Center, The Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada.|Department of Pediatrics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
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Gagnon
Trauma Center, The Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada.
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Grilli
Trauma Center, The Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada.|Department of Pediatrics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.|Canadian Hospitals Injury Reporting and Prevention Program, Montreal, Quebec, Canada.
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Friedman
Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA.|Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA.|Mass General Hospital for Children Sports Concussion Program, Boston, Massachusetts, USA.|Red Sox Foundation and Massachusetts General Hospital Home Base Program, Boston, Massachusetts, USA.
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Iverson
D000293:Adolescent; D001007:Anxiety / Q000517:prevention & control; D001265:Athletic Injuries / Q000534:rehabilitation*; D001924:Brain Concussion / Q000534:rehabilitation*; D003071:Cognition; D005081:Exercise Therapy; D005221:Fatigue; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D038223:Post-Concussion Syndrome / Q000175:diagnosis / Q000517:prevention & control*; D004856:Postural Balance
Pediatric; aerobics; children; mild traumatic brain injury; physiotherapy; post-concussion symptoms; sports