Rest and treatment/rehabilitation following sport-related concussion: a systematic review

  title={Rest and treatment/rehabilitation following sport-related concussion: a systematic review},
  author={Kathryn J Schneider and John J Leddy and Kevin M. Guskiewicz and Tad Seifert and Michael A. McCrea and Noah D. Silverberg and Nina Feddermann-Demont and Grant L. Iverson and Alix Hayden and Michael Makdissi},
  journal={British Journal of Sports Medicine},
  pages={930 - 934}
Aim or objective The objective of this systematic review was to evaluate the evidence regarding rest and active treatment/rehabilitation following sport-related concussion (SRC. [] Key Method Data sources MEDLINE (OVID), CINAHL (EbscoHost), PsycInfo (OVID), Cochrane Central Register of Controlled Trials (OVID), SPORTDiscus (EbscoHost), EMBASE (OVID) and Proquest DissertationsandTheses Global (Proquest) were searched systematically.

Do physical interventions improve outcomes following concussion: a systematic review and meta-analysis?

Subthreshold aerobic exercise appears to lower symptom scores but not time to recovery in concussed individuals, and individually tailored multimodal interventions have a worthwhile effect in providing faster return to sport and clinical improvement, specifically in those with persistent symptoms.

Aerobic Exercise for Sport-related Concussion: A Systematic Review and Meta-analysis

Symptom-limited aerobic exercise programs are beneficial in improving symptoms of adolescents after an SRC and good-quality studies are needed to determine effects on adults and on other outcomes.

Physical exercise for people with mild traumatic brain injury: A systematic review of randomized controlled trials.

It is demonstrated that the use of aerobic exercise is supported by mixed quality evidence and moderate certainty of evidence, yet there is limited evidence for the useof vestibular exercise for improving persistent symptoms in people with mTBI.

Methodology and Implementation of a Randomized Controlled Trial (RCT) for Early Post-concussion Rehabilitation: The Active Rehab Study

Outputs from the trial are expected to inform both research and clinical practice in post-concussion rehabilitation across all levels of sport and extend beyond civilian medicine to care for military personnel.

Mode and Intensity of Physical Activity During the Postacute Phase of Sport-Related Concussion: A Systematic Review.

Though the volume of literature at this time is limited, therapists should consider prescribing closely monitored individualized exercise programs utilizing progressive intensities when treating patients during the postacute phase of SRC.

The Effects of Including Aerobic Exercise in the Treatment Protocol of Concussions: A Systemic Review and Meta-analysis

While there is evidence that aerobic exercise is beneficial for children and adolescents with a concussion, more studies need to be completed focusing on this age group and the effects of aerobic exercise on concussion recovery.

The Role of Active Rehabilitation in Concussion Management: A Systematic Review and Meta-analysis

Current evidence supports the notion that physical activity is beneficial in decreasing postconcussive symptoms in both the acute and chronic phases after concussion, and results indicate that unimodal subthreshold aerobic activity may be the best course of action compared with multimodal interventions.

Treatment of Acute Sports-Related Concussion

After 24–48 h of rest, SRC patients may gradually resume cognitive and physical activity and return to sport should only occur once the patient is symptom free.

Rest and return-to-sport recommendations following sport-related concussion (PEDro synthesis)

The aim of the systematic review was to synthesise the literature related to rest and RTS/activity recommendations following sport-related concussion to provide precise evidence-informed guidelines in terms of timing, quantity and duration.



Cervico-vestibular physiotherapy in the treatment of individuals with persistent symptoms following sport related concussion: a randomised controlled trial

Participants who received multimodal physiotherapy treatment were more likely to achieve medical clearance before 8 weeks when compared with rest in individuals with persistent symptoms following an SRC.

Exercises for mechanical neck disorders.

No high quality evidence was found, indicating that there is still uncertainty about the effectiveness of exercise for neck pain and using specific strengthening exercises as a part of routine practice for chronic neck pain, cervicogenic headache and radiculopathy may be beneficial.

Cervicovestibular rehabilitation in sport-related concussion: a randomised controlled trial

A combination of cervical and vestibular physiotherapy decreased time to medical clearance to return to sport in youth and young adults with persistent symptoms of dizziness, neck pain and/or headaches following a sport-related concussion.

Exercises for mechanical neck disorders.

Low to moderate quality evidence supports the use of specific cervical and scapular stretching and strengthening exercise for chronic neck pain immediately post treatment and intermediate term, and cervicogenic headaches in the long term.

Symptom response following acute bouts of exercise in concussed and non-concussed individuals - a systematic narrative review.

Examining prescribed rest as treatment for adolescents who are slow to recover from concussion

A substantial percentage of adolescents with persistent symptoms following concussion showed improvement in symptoms and cognitive functioning following education, reassurance and 1-week of prescribed rest.

Benefits of Strict Rest After Acute Concussion: A Randomized Controlled Trial

Recommending strict rest for adolescents immediately after concussion offered no added benefit over the usual care, and adolescents’ symptom reporting was influenced by recommending strict rest.

The effect of recommending cognitive rest on recovery from sport-related concussion

Recommendations of prolonged periods of cognitive rest, particularly absences from school, should be approached cautiously given the limited evidence regarding the effects of Cognitive rest on recovery from concussion.

Frequency and Outcomes of a Symptom-Free Waiting Period After Sport-Related Concussion

The findings support improved adherence to clinical management guidelines through increased utilization of SFWPs after SRC through increased usage and duration in the current study samples.