{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T01:19:09Z","timestamp":1788484749134,"version":"build-2803163510"},"reference-count":50,"publisher":"Human Kinetics","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3,1]]},"abstract":"<jats:p><jats:italic><jats:bold>Clinical Scenario<\/jats:bold>:<\/jats:italic>Recent systematic reviews have shown that extended rest may not be beneficial to patients following concussion. Furthermore, recent evidence has shown that patient with postconcussion syndrome benefit from an active rehabilitation program. There is currently a gap between the ability to draw conclusions to the use of aerobic exercise during the early stages of recovery along with the safety of these programs.<jats:italic><jats:bold>Clinical Question<\/jats:bold>:<\/jats:italic>Following a concussion, does early controlled aerobic exercise, compared with either usual care or delayed exercise, improve recovery as defined by symptom duration and severity?<jats:italic><jats:bold>Summary of Key Findings<\/jats:bold>:<\/jats:italic>After a thorough literature search, 5 studies relevant to the clinical question were selected. Of the 5 studies, 1 study was a randomized control trial, 2 studies were pilot randomized controlled trials, and 2 studies were retrospective. All 5 studies showed that implementing controlled aerobic exercise did not have an adverse effect on recovery. One study showed early aerobic exercise had a quicker return to school, and another showed a 2-day decrease in symptom duration.<jats:italic><jats:bold>Clinical Bottom Line<\/jats:bold>:<\/jats:italic>There is sufficient evidence to suggest that early controlled aerobic exercise is safe following a concussion. Although early aerobic exercise may not always result in a decrease in symptom intensity and duration, it may help to improve the psychological state resulting from the social isolation of missing practices and school along with the cessation of exercise. Although treatments continue to be a major area of research following concussion, management should still consist of an interdisciplinary approach to individualized patient care.<jats:italic><jats:bold>Strength of Recommendation<\/jats:bold>:<\/jats:italic>There is grade B evidence to support early controlled aerobic exercise may reduce the duration of symptoms following recovery while having little to no adverse events.<\/jats:p>","DOI":"10.1123\/jsr.2019-0187","type":"journal-article","created":{"date-parts":[[2019,10,18]],"date-time":"2019-10-18T15:44:37Z","timestamp":1571413477000},"page":"360-366","source":"Crossref","is-referenced-by-count":10,"title":["Early Controlled Exercise and Timing of Treatment Following Concussion: A Critically Appraised Topic"],"prefix":"10.1123","volume":"29","author":[{"given":"Nicholas","family":"Hattrup","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Gray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Krumholtz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara C.","family":"Valovich McLeod","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"100","reference":[{"key":"ref241","doi-asserted-by":"crossref","first-page":"1534","DOI":"10.1080\/02699052.2018.1502894","article-title":"Key ingredients to an active rehabilitation programme post-concussion: perspectives of youth and parents","volume":"32","author":"Hunt","year":"2018","journal-title":"Brain Inj"},{"key":"ref441","doi-asserted-by":"crossref","first-page":"2325967117745033","DOI":"10.1177\/2325967117745033","article-title":"Lived experiences of adolescent athletes following sport-related concussion","volume":"5","author":"Valovich McLeod","year":"2017","journal-title":"Orthop J Sports Med"},{"key":"ref01","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1136\/bjsports-2017-097699","article-title":"Consensus statement on concussion in sport\u2014the 5th international conference on concussion in sport held in Berlin, October 2016","volume":"51","author":"McCrory","year":"2017","journal-title":"Br J Sports Med"},{"key":"ref61","doi-asserted-by":"crossref","first-page":"E119","DOI":"10.3390\/brainsci7090119","article-title":"COACH CV: the seven clinical phenotypes of concussion","volume":"7","author":"Craton","year":"2017","journal-title":"Brain Sci"},{"key":"ref151","doi-asserted-by":"crossref","first-page":"e000404","DOI":"10.1136\/bmjsem-2018-000404","article-title":"Feasibility of a postacute structured aerobic exercise intervention following sport concussion in symptomatic adolescents: a randomised controlled study","volume":"4","author":"Micay","year":"2018","journal-title":"BMJ Open Sport Exerc Med"},{"key":"ref291","doi-asserted-by":"crossref","first-page":"262","DOI":"10.4085\/1052-6050-51.6.06","article-title":"Rest and return to activity after sport-related concussion: a systematic review of the literature","volume":"52","author":"McLeod","year":"2017","journal-title":"J Athl Train"},{"key":"ref261","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1001\/jama.1984.03350040068030","article-title":"The second impact in catastrophic contact-sports head trauma","volume":"252","author":"Saunders","year":"1984","journal-title":"JAMA"},{"key":"ref431","doi-asserted-by":"crossref","first-page":"E11","DOI":"10.1097\/HTR.0000000000000339","article-title":"Is there an optimal time to initiate an active rehabilitation protocol for concussion management in children? 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