Determining the optimal volume of moderate-to-vigorous-intensity physical activity in the early stages postconcussion and its correlation with subsequent symptom severity is crucial for providing effective management opinions.
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According to an Original Investigation on Physical Medicine and Rehabilitation published in JAMA Network Open, Children and adolescents with acute concussion who engaged in 259 minutes of cumulative moderate-to-vigorous physical activity (cMVPA) during the first week post-injury and 565 minutes of cMVPA during the second-week post-injury experienced lower symptom burden at one week and two weeks post-injury.
The study aims to explore the connection between physical activity and symptom burden in children postconcussion, including the likelihood of persisting symptoms at two and four weeks post-injury.
This study analyzed data from a randomized clinical trial conducted from March 2017 to December 2019 at 3 Canadian pediatric emergency departments. Participants aged 10-17 with acute concussion of less than 48 hours were included. Analysis was conducted from July 2022 to December 2023.
cMVPA after injury was measured using accelerometers worn on the waist 24 hours a day for 13 days after the injury. The measurements were valid if participants had at least four days of accelerometer data and, at most, three consecutive days of missing data. cMVPA at one week and two weeks post-injury was defined as cMVPA for seven days and 13 days post-injury, respectively.
Key findings from the study are:
- 267/456 children were female, with a mean age of 12.9.
- Participants with higher cMVPA had lower HBI scores at 1 and 2 weeks post-injury, but not at four weeks post-injury with differences of -5.45, -2.85 and -1.24, respectively (75th percentile vs 25th percentile).
- Symptom burden did not decrease beyond the 75th percentile for cMVPA at 1 and 2 weeks post-injury. The odds ratio for the connection between the 75th and 25th percentiles of cMVPA and PSAC was 0.48 at two weeks.
Study strengths include a large sample, objective evaluation of cMVPA, enhanced generalizability, external validity, use of the standardized definition of PSAC, and enhanced reliability of results.
Children and adolescents with acute concussion who engaged in 259 minutes of moderate-to-vigorous physical activity (cMVPA) during the first-week post-injury and 565 minutes during the second-week post-injury experienced lower symptom burden at one and two weeks post-injury. At two weeks post-injury, higher cMVPA volume was associated with a 48% reduced odds of PSAC compared to lower cMVPA volume.
Reference
Ledoux A, Sicard V, Bijelić V, et al. Optimal Volume of Moderate-to-Vigorous Physical Activity Postconcussion in Children and Adolescents. JAMA Netw Open. 2024;7(2):e2356458. doi:10.1001/jamanetworkopen.2023.56458
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