From the Department of Medicine, Division of Physical Medicine and Rehabilitation, Toronto Rehabilitation Institute, University of Toronto, Toronto, Ontario, Canada.
Am J Phys Med Rehabil. 2020 Mar;99(3):257-264. doi: 10.1097/PHM.0000000000001340.
In recent years, there has been a shift away from rest until total symptom resolution after concussion, due to the potential adverse consequences of inactivity. Aerobic exercise has been increasingly investigated for the treatment of postconcussion syndrome, whereby symptoms persist beyond 4 wks. The aim of this review was to systematically review the literature on subsymptom threshold aerobic exercise as a treatment for postconcussion syndrome. We conducted systematic literature searches in databases: MEDLINE (Ovid), CINAHL, PubMed, and Embase. After thorough review, 12 articles met the eligibility criteria and were included in the systematic review. The quality of selected studies was low to moderate. Subsymptom threshold aerobic exercise was associated with improvement in symptoms in patients with postconcussion syndrome for all included studies. The most commonly used protocols incorporated 20 mins of exercise at 80% of the heart rate that provoked symptoms, 5-6 days per week, with no adverse events documented. However, there was considerable variation in exercise protocols, and many studies incorporated subsymptom threshold aerobic exercise as part of a broader rehabilitation plan. Evidence supports subsymptom threshold aerobic exercise as a promising treatment for postconcussion syndrome. Further studies are required to delineate the optimal intensity, duration, and frequency of exercise for postconcussion syndrome in a variety of populations.
近年来，由于不活动可能带来的不良后果，人们不再提倡脑震荡后完全消除症状再休息，而是倾向于活动。有氧运动越来越多地被用于治疗脑震荡后综合征，这种综合征的症状会持续超过 4 周。本综述的目的是系统地回顾亚症状阈有氧运动作为脑震荡后综合征治疗方法的文献。我们在 MEDLINE（Ovid）、CINAHL、PubMed 和 Embase 数据库中进行了系统的文献检索。经过彻底审查，有 12 篇文章符合入选标准，并纳入了系统评价。入选研究的质量为低到中等。所有纳入的研究都表明，亚症状阈有氧运动可改善脑震荡后综合征患者的症状。最常用的方案包括以 80%引发症状的心率进行 20 分钟运动，每周 5-6 天，没有记录到不良事件。然而，运动方案存在很大差异，许多研究将亚症状阈有氧运动作为更广泛的康复计划的一部分。有证据表明，亚症状阈有氧运动是治疗脑震荡后综合征的一种很有前途的方法。需要进一步的研究来确定在不同人群中治疗脑震荡后综合征的最佳运动强度、持续时间和频率。
