Powell Cara, McCaulley Brianna, Scott Brosky Zachary, Stephenson Tyler, Hassen-Miller Amy
Department of Physical Therapy, Walsh University North Canton, OH, USA.
Int J Sports Phys Ther. 2020 Oct;15(5):650-658. doi: 10.26603/ijspt20200650.
Adolescent athletes are experiencing an increased number of concussions. There is currently a debate within the medical community regarding the most effective and safe treatment approach for this population, post-concussion. Interventions currently range from cognitive and physical rest to various types of physical activity, including aerobic exercise. While there are systematic reviews that focus on rest as the main intervention, there are no other systematic reviews that focus on the effects of aerobic exercise on concussion recovery in adolescent athletes.
The aim of this systematic review and meta-analysis was to investigate the effectiveness of aerobic exercise on concussion recovery for adolescent athletes compared to an alternate intervention.
Systematic Review and Meta-Analysis.
A computer-based search (: adolescent athletes with concussions, : aerobic exercise, : non-aerobic interventions, : symptom severity and recovery time) was performed. Databases including PubMed, CINAHL, SPORTdiscus, ProQuest, and Scopus were searched up to December 2019 for randomized controlled trials published since 1965. A hand search of relevant articles and exploration of grey literature was also completed. Data were extracted for the following information: interventions prescribed, outcome measures, and overall results of the study. A meta-analysis was performed for aerobic interventions using standardized mean difference as the summary measure of effect.
Five studies, which all held a moderate to low risk of bias according to the PEDro scale, met the inclusion criteria for this systematic review and meta-analysis. Overall results favored aerobic exercise for both acute and prolonged recovery symptoms as demonstrated by a decrease in symptom severity and improved recovery time. The meta-analysis revealed a moderate effect size in favor of the intervention group (SMD: 0.51, CI: 0.02, 0.81, p=0.00) when looking at the three outcome measures combined: Post-Concussion Symptom Scale, Post-Concussion Symptom Inventory, and recovery time.
The results of this systematic review and meta-analysis indicate that there is currently moderately significant evidence in support of implementing an aerobic exercise program for adolescent athletes with both acute and prolonged recovery concussion symptoms. Additional higher quality studies are needed to continue to study the effectiveness of aerobic exercise in post-concussion treatment of adolescents.
1a.
青少年运动员遭受脑震荡的次数日益增多。目前，医学界对于该群体脑震荡后最有效且安全的治疗方法存在争议。当前的干预措施涵盖从认知和身体休息到各类体育活动，包括有氧运动。虽然有系统评价聚焦于以休息作为主要干预手段，但尚无其他系统评价关注有氧运动对青少年运动员脑震荡恢复的影响。
本系统评价和荟萃分析的目的是探究与其他干预措施相比，有氧运动对青少年运动员脑震荡恢复的有效性。
系统评价和荟萃分析。
进行基于计算机的检索（检索词：患有脑震荡的青少年运动员、有氧运动、非有氧运动干预、症状严重程度和恢复时间）。截至2019年12月，对包括PubMed、CINAHL、SPORTdiscus、ProQuest和Scopus在内的数据库进行检索，以查找自1965年以来发表的随机对照试验。还完成了对相关文章的手工检索以及灰色文献的探索。提取以下信息的数据：规定的干预措施、结局指标以及研究的总体结果。对有氧运动干预进行荟萃分析，使用标准化均数差值作为效应的汇总指标。
五项研究根据PEDro量表均具有中等到低的偏倚风险，符合本系统评价和荟萃分析的纳入标准。总体结果表明，有氧运动对急性和长期恢复症状均有益，表现为症状严重程度降低和恢复时间改善。当综合考虑三项结局指标：脑震荡后症状量表、脑震荡后症状清单和恢复时间时，荟萃分析显示干预组有中等效应量（标准化均数差值：0.51，可信区间：0.02，0.81，p = 0.00）。
本系统评价和荟萃分析的结果表明，目前有适度显著的证据支持为患有急性和长期恢复性脑震荡症状的青少年运动员实施有氧运动计划。需要更多高质量研究继续探究有氧运动在青少年脑震荡后治疗中的有效性。
1a。
