Use of Graded Exercise Testing in Concussion and Return-to-Activity Management

@article{Leddy2013UseOG,
  title={Use of Graded Exercise Testing in Concussion and Return-to-Activity Management},
  author={John J Leddy and Barry S Willer},
  journal={Current Sports Medicine Reports},
  year={2013},
  volume={12},
  pages={370–376}
}
Concussion is a physiologic brain injury that produces systemic and cognitive symptoms. [] Key Method The use of a provocative exercise test is consistent with world expert consensus opinion on establishing physiologic recovery from concussion.
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The Role of Controlled Exercise in Concussion Management
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Evaluation and treatment approaches based on the physiology of concussion suggest that exercise is medicine for concussion, potentially adding a new dimension to concussion care to help safely speed recovery and prevent PPCS in some patients.
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Management for suspected concussion begins with immediate removal from play and requires clinical follow-up, and initial treatment consists of a reduction in cognitive activity and physical rest.
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TLDR
The expected recovery pattern for PCS was found, regardless of exercise, while for neurocognition, recovery was dependent on the degree of cognitive demand, and there was an unexpected reduction in performance from Day 2 to Day 10.
Early Aerobic Exercise for the Treatment of Acute Pediatric Concussions.
TLDR
The purpose of the paper was to review and evaluate the available literature on the implementation of aerobic exercise for the treatment of acute pediatric concussion and the risk for persistent postconcussive symptoms, particularly in pediatric populations.
Impact of Moderate Exercise on Post-concussive Symptoms and Cognitive Function after Concussion in Children and Adolescents Compared to Healthy Controls.
TLDR
Preliminary support for the use of moderate exercise for the reduction of concussion post-symptom, as suggested in recent clinical guidelines, is provided.
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TLDR
The physiological effects of exercise on concussion are especially important for athletes because some athletes with PCS have exercise intolerance that may result from altered control of cerebral blood flow.
Graded aerobic treadmill testing in pediatric sports-related concussion: safety, clinical use, and patient outcomes.
TLDR
Graded aerobic treadmill testing is a safe, tolerable, and clinically valuable tool that can assist in the evaluation and management of pediatric SRC and future research is needed to confirm the clinical value of this tool in return-to-play decision making.
Why exercise may be beneficial in concussion rehabilitation: A cellular perspective.
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