Aerobic Exercise or Rest after a Sports-related Concussion?

What follows is a recent research report for the American Academy of Sports Medicine:

Rest has long been the cornerstone of health care professionals’ recommendations for optimal recovery from a sports-related concussion. A recently published systematic review suggests that gradually resuming aerobic exercise like cycling and running as early as three days after a concussion is safe and likely beneficial in reducing symptoms as long as exertion does not result in worsening of symptoms. This systematic review examined seven randomized clinical trials (total of 326 adolescents) comparing the effectiveness of exercise programs to relative rest following a sports-related concussion. The intensity of aerobic exercises varied between studies from low to moderate. Although limitations to some of the included studies were found, taken together, these studies show that aerobic exercise is not associated with more adverse events compared to rest and that it is likely beneficial in reducing the intensity of symptoms such as headache and dizziness. In clinical practice, the results of this study suggest that, even in the presence of residual concussion symptoms after a brief initial rest period, clinicians could recommend a gradual progression toward moderate-intensity aerobic exercise, as long as activity does not result in an increase of symptoms.

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Lawyer Elected Chairwoman Brain Injury Association of America

Shana De Caro, a partner in the New York personal injury law firm, De Caro & Kaplen, LLP, has been elected as chairwoman of the Brain Injury Association of America (BIAA) for 2021.

De Caro has advocated on behalf of individuals and their families following a traumatic or acquired brain injury for over 35 years, and is respected nationally for her knowledge, passion, and drive to protect the rights of those who have sustained brain damage. She has previously served as vice chair, secretary, and board of directors’ member of the Brain Injury Association of America.

In accepting her new position, De Caro said, “I am excited and humbled to accept this new role on behalf of the over 5.2 million Americans living with disability caused by brain trauma.”

Founded in 1980, the Brain Injury Association of America is the oldest, largest, and only nationwide brain injury advocacy organization in the United States. As the voice of brain injury, BIAA “provides help, hope, and healing for the millions of Americans who sustain this life-altering injury.”

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$2.9 million NIH grant will help IU researcher expand work on subconcussive impacts

Every year, nearly 2.5 million U.S. high school athletes participate in contact sports. Each of these athletes sustains an average of 650 subconcussive head impacts in a single season, hits that can negatively affect brain health.

A $2.9 million grant from the National Institutes of Health will help researchers at Indiana University determine whether, and to what extent, repetitive subconcussive head impacts — impacts that do not trigger clinically detectable signs and symptoms of concussion — negatively affect brain health in adolescents. If applied repeatedly, subconcussive impacts can trigger subclinical cellular and molecular disruptions in brain cells. Ultimately, the IU research will help establish safety guidelines for young athletes exposed to head impacts.

This large-scale study uses state-of-art neurologic assessments to monitor brain health of high school football players,” said study lead Kei Kawata, assistant professor of kinesiology at the IU School of Public Health-Bloomington. “This will be a monumental study to understand safe or unsafe levels of head impacts exposure in high school football, so we can provide a safe platform for players to enjoy football.”

The project is an extension of a study Kawata piloted in 2019 focusing on subconcussive hits among football athletes at Bloomington North High School in Indiana. The current project will span four years and include athletes from Bloomington High School North, Bloomington High School South, Edgewood High School and Mooresville High School.

Adolescence is an especially vulnerable time for neurodevelopment. While head injuries in athletes continue to be a focus of researchers throughout the world, Kawata’s research is unique in that it focuses on repetitive subconcussive head injury that does not necessarily trigger immediate symptoms such as headache, dizziness and disorientation.

Using computerized mouthguards, neurological imaging and blood samples, Kawata and his team will measure every impact athletes endure during play, assessing players’ potential eyeball and eyelid movement impairment, information processing, and blood biomarkers.

Kawata said that playing sports provides young people with important skills and lifelong memories. He said the goal of his work is to make sure young athletes are enjoying sports in the safest way possible.

That goal is important to athletic leaders such as Andrew Hodson, who said that working with researchers at IU has helped inform his school’s athletic programs and keep students safe.

“At the (Monroe County Community School Corp.), we place student-athletes’ health and safety as our highest priority,” said Hodson, athletic director at Bloomington High School North. “We are thankful for the long-standing relationship we have with Dr. Kawata and IU, and for this critical study that addresses an important safety concern for our athletes and their parents.

“Athletics provides meaningful opportunities for students to engage in physical activity and be part of a team, and we want this to continue in the safest way possible. We look forward to continuing to be a part of this important project.”

Others contributing to the study include Jesse Steinfeldt, IU School of Education Bloomington; Sharlene Newman and Hu Cheng, IU Bloomington College of Arts and Sciences’ Department of Psychological and Brain Sciences; Jeffrey Bazarian, University of Rochester; and Keisuke Ejima, Zhongxue Chen and Jon Macy, all from the School of Public Health-Bloomington.

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