Use of Subthreshold Aerobic Activity Versus Rest Alone for Treatment in Patients Diagnosed with a Concussion
Athletic Training M.S.
Background: Treatment of concussions has historically included rest until asymptomatic, but the latest concussion consensus statement questioned the effectiveness of this treatment. Ambiguity continues to prevail amongst sports medicine practitioners on whether rest or subthreshold aerobic activity will aid in quicker symptom resolution and shorter duration of the injury. Purpose: Do patients, who have been diagnosed with a concussion, have decreased symptoms and a quicker return-to-play when subthreshold aerobic exercise is used in their treatment versus rest alone? Results: Twenty-five scholarly articles were analyzed using a matrix format and were evaluated with the PEDro Scale, CASP Questionnaire, or a series of four questions. Twenty-three of the 25 studies either recommended subthreshold activity, demonstrated that it was safe, found participating in an aerobic intervention was not more detrimental than rest, or concluded rest to be harmful in concussion rehabilitation. Three studies recommended rest as a quality intervention for concussion treatment. Conclusion: The use of subthreshold aerobic activity as a treatment for patients diagnosed with a concussion is safe and more effective for resolution of symptoms and return to baseline activities than rest. Instead of waiting for symptoms to resolve, an athlete should be started on a protocol introducing subthreshold aerobic activity as soon as a few days post-injury. If treatment has already been delayed, and the patient has been symptomatic for months, they will still benefit from subthreshold aerobic activity. Implications for Research and Practice: These findings challenge the current clinical practice of rest for post-concussion treatment. The literature encourages athletic trainers and physicians who manage concussions to adopt a treatment protocol with subthreshold aerobic activity. Further research is needed on excellent quality articles with a larger number of participants and investigating when subthreshold aerobic activity should be initiated post-concussion for optimal results.
Athletic Training M.S.
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Havlicek, K. R. (2020). Use of Subthreshold Aerobic Activity Versus Rest Alone for Treatment in Patients Diagnosed with a Concussion [Masterʼs thesis, Bethel University]. Spark Repository. https://spark.bethel.edu/etd/276