Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY.
UBMD Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY.
Med Sci Sports Exerc. 2022 Sep 1;54(9):1410-1416. doi: 10.1249/MSS.0000000000002952. Epub 2022 Apr 28.
There is growing evidence that subsymptom threshold aerobic exercise speeds recovery from sport-related concussion (SRC). It is not known whether there is a direct relationship between adherence to a personalized exercise prescription and recovery or if initial symptom burden affects adherence to the prescription.
This study was a planned secondary analysis of one arm of a randomized controlled trial. Male and female adolescent athletes (age 13-18 yr) presenting within 10 d of SRC were given aerobic exercise prescriptions based on their heart rate threshold at the point of exercise intolerance on a graded treadmill test. Adherence was determined objectively with HR monitors and compared against time to recovery. Participants who completed at least two-thirds of their aerobic exercise prescription were considered to be adherent.
Sixty-one percent of adolescents met the adherence criterion. Those who were adherent were more symptomatic and were more exercise intolerant at their initial visit, yet they recovered faster than those who were not adherent (median recovery time, 12 (interquartile range, 9-22) d vs 21.5 (interquartile range, 13-29.8) d; P = 0.016). On linear regression, adherence during week 1 was inversely related to recovery time ( β = -0.002 (-0.003, 0.0), P = 0.046) and to initial exercise tolerance ( β = -0.886 (-1.385, -0.387), P < 0.001), but not to initial symptom severity ( β = 0.545 (-0.232, 1.323), P = 0.146). No adverse events or near misses were reported.
Adherence to individualized subsymptom threshold aerobic exercise within the first week of evaluation is associated with faster recovery from SRC. The data suggest that initial degree of exercise intolerance, but not initial symptom severity, affects adherence to aerobic exercise prescribed to adolescents within 10 d of SRC.
越来越多的证据表明，亚症状阈有氧运动可以加速运动相关性脑震荡（SRC）的恢复。目前尚不清楚是否存在个性化运动处方的依从性与恢复之间的直接关系，或者初始症状负担是否会影响对处方的依从性。
这是一项随机对照试验的一个手臂的计划二次分析。在 SRC 后 10 天内出现的男性和女性青少年运动员（年龄 13-18 岁）根据他们在分级跑步机测试中运动不耐受时的心率阈值接受有氧运动处方。通过心率监测器客观地确定依从性，并将其与恢复时间进行比较。完成至少三分之二有氧运动处方的参与者被认为是依从的。
61%的青少年符合依从性标准。那些依从的人在最初就诊时症状更严重，运动耐受力更差，但他们比不依从的人恢复得更快（中位数恢复时间，12（四分位间距，9-22）d 与 21.5（四分位间距，13-29.8）d；P = 0.016）。在线性回归中，第 1 周的依从性与恢复时间呈负相关（β = -0.002（-0.003，0.0），P = 0.046）和初始运动耐受力（β = -0.886（-1.385，-0.387），P < 0.001），但与初始症状严重程度无关（β = 0.545（-0.232，1.323），P = 0.146）。没有报告不良事件或险些发生。
在评估的第一周内，对个性化亚症状阈有氧运动的依从性与 SRC 的快速恢复相关。数据表明，初始运动不耐受程度，但不是初始症状严重程度，影响了对 SRC 后 10 天内青少年规定的有氧运动的依从性。
