Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, United States.
UBMD Department of Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, United States; PhD Program in Biomedical Science, Neuroscience, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, United States.
Arch Phys Med Rehabil. 2019 Dec;100(12):2267-2275. doi: 10.1016/j.apmr.2019.07.003. Epub 2019 Aug 1.
To compare a sample of adolescents with sport-related concussion (SRC) who were prescribed rest with 2 arms of a randomized controlled trial comparing aerobic exercise with placebo-like stretching. We also compared sex differences across the 3 approaches to treatment.
Quasi-experimental trial.
University concussion management clinics.
Adolescent athletes (aged 13-18 years) presenting within 10 days of SRC (mean, 5 days after injury) received a recommendation for rest (rest group [RG], n=48, 15.4±1y, 25% female). Their outcomes were compared with matched samples of adolescents assigned to aerobic exercise (exercise group [EG], n=52, 15.3±2y, 46% female) or placebo-like stretching (placebo group [PG], n=51, 15.4±2y, 47% female) (N=151).
The primary outcome was median days from injury to recovery. The secondary outcome was proportion classified as normal recovery (<30d) or delayed recovery (≥30d).
The RG recovered in 16 days (interquartile range, 9.25-23.25d), which was significantly delayed (P=.020) compared with EG (13d; interquartile range, 10-18.5d). The PG recovered in 17 days (interquartile range, 13-23d). Four percent of the EG, 14% of the PG, and 13% of the RG had delayed recovery (P=.190). There was no difference in recovery time or delayed recovery between male participants and female participants across groups. Female participants prescribed rest experienced an increase in symptoms vs the other groups (P=.013).
Relative rest and a placebo-like stretching program were very similar in days to recovery and symptom improvement pattern after SRC. Both conditions were less effective than subsymptom threshold aerobic exercise. Female adolescents appear to be susceptible to symptom increase when prescribed rest.
比较一组接受与运动相关的脑震荡（SRC）相关的休息处方的青少年样本与随机对照试验的 2 个手臂，比较有氧运动与安慰剂样伸展的疗效。我们还比较了 3 种治疗方法的性别差异。
准实验试验。
大学脑震荡管理诊所。
青少年运动员（年龄 13-18 岁）在 SRC 后 10 天内就诊（平均 5 天），接受休息建议（休息组[RG]，n=48，15.4±1 岁，25%为女性）。他们的结果与分配给有氧运动（运动组[EG]，n=52，15.3±2 岁，46%为女性）或安慰剂样伸展（安慰剂组[PG]，n=51，15.4±2 岁，47%为女性）的青少年匹配样本进行比较（n=151）。
主要结局是从损伤到恢复的中位数天数。次要结局是正常恢复（<30d）或延迟恢复（≥30d）的比例。
RG 在 16 天（四分位距，9.25-23.25d）内恢复，与 EG（13d；四分位距，10-18.5d）相比，恢复明显延迟（P=.020）。PG 在 17 天（四分位距，13-23d）内恢复。EG 组有 4%、PG 组有 14%、RG 组有 13%的患者延迟恢复（P=.190）。各组男性和女性参与者的恢复时间或延迟恢复无差异。与其他组相比，接受休息治疗的女性参与者的症状增加（P=.013）。
相对休息和安慰剂样伸展方案在 SRC 后的恢复时间和症状改善模式上非常相似。这两种情况都不如亚症状阈值有氧运动有效。女性青少年在接受休息治疗时似乎容易出现症状增加。
