Tag Archives: treatment
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.
The results, published today in JAMA Neurology, suggest delays in seeking treatment can lead to unnecessarily longer recovery.
“Our study emphasizes the importance of seeking appropriate, specialized care early on. Delaying clinical care following a concussion leaves patients to deal with symptoms on their own and negates the positive effects of early and targeted interventions,” said senior author Anthony Kontos, Ph.D., research director at Pitt’s Sports Medicine Concussion Program.
A concussion is a mild traumatic brain injury caused by a jolt to the head or body that disrupts the function of the brain. This injury can result in physical, cognitive, emotional and/or sleep-related symptoms that may or may not involve a loss of consciousness. The symptoms can last from several minutes, to days, weeks, months or longer.
Kontos and his team analyzed 162 athletes with diagnosed concussion injuries between the ages of 12 and 22 years. Athletes treated within the first week of injury recovered faster than athletes who did not receive care until eight days to three weeks after injury. Once in care, the length of time spent recovering was the same for athletes evaluated within the first week of injury compared to those evaluated eight days to three weeks post-injury, indicating the days before initial clinical care was the primary driver for the longer recovery duration.
“Early clinical care including behavioral management interventions and targeted exertion, vestibular and oculomotor rehabilitation exercises also may minimize missed time at work, school or sports, helping the patient return to a normal routine sooner,” said Michael “Micky” Collins, Ph.D., executive and clinical director, UPMC Sports Medicine Program.
Kontos and his colleagues say future research should look into the biological reasons why earlier engagement with care promotes faster recovery, as well as explore whether their findings could apply to other types of patients, such as military personnel.
Co-authors include Michael Collins, Ph.D., Alicia Trbovich, Ph.D., Nathan Ernst, Psy.D., Kouros Emami, Psy.D., Brandon Gillie, Ph.D., Jonathan French, Psy.D., and Cyndi Holland, M.P.H., all of Pitt; Kendra Jorgensen-Wagers, Ph.D., of Landstuhl Regional Medical Center; and R.J. Elbin, Ph.D., of University of Arkansas.
Physicians, scientists, athletic trainers, coaches, officials and retired pro players from the U.S. and Canada will discuss the science of concussion, including prevention, diagnosis, treatment and future research. The summit focuses on ice hockey, but concussion-related topics apply to all sports.
The sessions include:
- “Which Hockey Players are at Greatest Risk and Why?
- “Can Financial Concerns and Pending Litigation Reduce Concussions in Pro Hockey?”
- “The Brain’s Response to Concussive Events: Updates on the Neurometabolic Cascade”
- “Pharmacologic Interventions Available now and on the Horizon”
- “Fish Oils, Supplements and their Neuroprotective Effects”
“Ultimately, we’re coming together to make the sport safer for our athletes,” says Michael Stuart, M.D., orthopedic surgeon and co-director, Mayo Clinic Sports Medicine. “Athletes at all levels are bigger, stronger and faster. Therefore, we must improve our ability to diagnose, treat and prevent traumatic brain injury.”
As with the first two summits in 2010 and 2013, participants will develop recommendations to improve the safety of the sport. Panels featuring former hockey players, medical providers and experts with coaching, officiating and athletic training backgrounds will provide ideas for potential solutions.
Past recommendations helped foster rule changes, including penalties for all hits to the head, a delay in body checking until the 14-and-under level and the elimination of dangerous acts, such as checking from behind. After these rule changes, Minnesota Hockey/Mayo Clinic Sports Medicine data showed a significant decline in penalties related to checking from behind.
“To reduce concussions in hockey, we must change the mindset and behavior of players, coaches and fans,” says Aynsley Smith, Ph.D., sport and exercise psychologist and concussion investigator at Mayo Clinic Sports Medicine. “From a young age, athletes need to learn proper body control and stick play to shift the focus from checking to improving skills. We are making progress, but there is more to do.”
Mayo Clinic Sports Medicine is facilitating this conference with support from USA Hockey, International Ice Hockey Federation, Thorne Science, Hockey Equipment Certification Committee, American College of Sports Medicine, the Johansson-Gund Endowment, the Brian Mark Foundation and the Martineau Gift.
Members of the media who want to attend or interview participants should RSVP to the contact below by Thursday, Sept. 21.