Active rehabilitation
| Paper | Study type/setting | Subject characteristics | Inclusion criteria | Outcome measures | Findings/results |
|---|---|---|---|---|---|
| Gagnon et al63 | Prospective cohort (tertiary referral centre) | N=16 Children and adolescents (aged 10–17 years) | Postconcussion symptoms >4 weeks | Symptoms checklist, clinical examination, balance testing, coordination testing | Used a graded rehabilitation programme (beginning with submaximal aerobic training that is, 15 min on a treadmill or stationary bike, then introducing sports-specific training drills for 10 min) Found a significant increase in exercise tolerance and reduction in symptom score (30.0±20.8 at presentation to 6.7±5.7 at discharge) Mean duration of intervention 4.4±2.6 weeks |
| Leddy et al64 | Prospective cohort (University concussion clinic) | N=12 (6 athletes, 6 non-athletes) | Symptoms >6 weeks following concussion (5 sports related, 1 motor vehicle accident) | Graded symptom checklist, graded exercise treadmill test (Balke protocol) | Exercise at an intensity of 80% of the maximum heart rate achieved on the treadmill test before the exacerbation of symptoms10 of the 12 reported being symptom-free at rest Athletes recovered faster than non-athletes Rate of symptom improvement was directly related to exercise intensity achieved |
| Baker et al65 | Retrospective case series | N=91 (63 had follow-up phone assessment 4–73 months postinjury) | Symptoms >3 weeks | Subjective symptom reporting, graded exercise treadmill test (Balke protocol) | 41/57 Who completed the exercise programme returned to full daily functioning |