Lempke Landon, Jaffri Abbis, Erdman Nicholas
J Sport Rehabil. 2019 Jan 1;28(1):99-105. doi: 10.1123/jsr.2017-0217. Epub 2018 Oct 13.
Clinical Scenario: Currently, rest following concussion serves as the keystone of concussion treatment, but substantial evidence to support it is lacking. Recent literature suggests that early physical activity may be beneficial in reducing concussion symptoms which may influence clinical recovery time. Clinical Question: Does early physical activity decrease postconcussion symptoms compared to physical rest following concussion? Summary of Key Findings: A total of 5 articles were included that examined symptom duration changes at multiple time points. All 5 studies utilized follow-up time points compared to initial examination, but there was variance in the specific time points reported. Two studies employed control groups and compared strict or recommended rest to early activity or limited rest. Three studies were observational studies that directly compared baseline measurements to follow-up assessments. Clinical Bottom Line: Current evidence suggests that early physical activity in the acute phase following a concussion may decrease the time needed for symptom resolution compared to immediate rest. Strength of Recommendation: Using Centre for Evidence-Based Medicine 2011 level 3 evidence and higher, the results suggest that early physical activity during the acute phase of a concussion may decrease symptom duration; however, a lack of high-quality studies and inconsistent interventions are limitations to this recommendation.
目前，脑震荡后休息是脑震荡治疗的关键，但缺乏支持这一点的充分证据。最近的文献表明，早期体育活动可能有助于减轻脑震荡症状，这可能会影响临床恢复时间。临床问题：与脑震荡后身体休息相比，早期体育活动是否能减轻脑震荡后症状？主要发现总结：共纳入5篇文章，这些文章在多个时间点检查了症状持续时间的变化。所有5项研究都采用了与初次检查相比的随访时间点，但报告的具体时间点存在差异。两项研究采用了对照组，将严格或推荐的休息与早期活动或有限休息进行了比较。三项研究是观察性研究，直接将基线测量与随访评估进行了比较。临床要点：目前的证据表明，与立即休息相比，脑震荡后急性期的早期体育活动可能会减少症状缓解所需的时间。推荐强度：根据2011年循证医学中心3级及以上证据，结果表明脑震荡急性期的早期体育活动可能会缩短症状持续时间；然而，缺乏高质量研究和干预措施不一致是这一推荐的局限性。
