Graded Combined Aerobic Resistance Exercise (CARE) to Prevent or Treat the Persistent Post-concussion Syndrome

Sullivan, Karen A.; Hills, Andrew P.

doi:10.1007/s11910-018-0884-9

Cited by 14 publications

(8 citation statements)

References 97 publications

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“…Recent studies investigated physical (e.g. aerobic exercise; Sullivan, Hills, & Iverson, 2018) and cognitive (e.g. light cognitive activity; Reed et al, 2019) treatment strategies to aid recovery, but these methods do not directly target emotional and psychological symptoms.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Effects of Meditation, Yoga, and Mindfulness‐Based Interventions for Chronic Symptoms of Mild Traumatic Brain Injury: A Systematic Review and Meta‐Analysis

Acabchuk

Brisson

Park

et al. 2020

Applied Psych Health & Well

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Background Chronic symptoms of mild traumatic brain injury (mTBI) vary greatly and are difficult to treat; we investigate the impact of meditation, yoga, and mindfulness‐based interventions on this treatment group. Method Search included four databases, allowing studies of any design containing pre/post outcomes for meditation, yoga, or mindfulness‐based interventions in people suffering from brain injury acquired by mechanical force. Analyses used robust variance estimation to assess overall effects and random‐effects models for selected outcomes; we evaluated both between‐ and within‐group changes. Results Twenty studies (N = 539) were included. Results revealed significant improvement of overall symptoms compared to controls (d = 0.41; 95% CI [0.04, 0.77]; τ2 = 0.06), with significant within‐group improvements in mental health (d = 0.39), physical health (d = 0.39), cognitive performance (d = 0.24), quality of life (d = 0.39), and self‐related processing (d = 0.38). Symptoms showing greatest improvement were fatigue (d = 0.96) and depression (d = 0.40). Findings were homogeneous across studies. Study quality concerns include lack of randomisation, blinding, and recording of adverse events. Conclusions This first‐ever meta‐analysis on meditation, yoga, and mindfulness‐based interventions for chronic symptoms of mTBI offers hope but highlights the need for rigorous new trials to advance clinical applications and to explore mechanistic pathways.

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Section: Introductionmentioning

confidence: 99%

Therapeutic Effects of Meditation, Yoga, and Mindfulness‐Based Interventions for Chronic Symptoms of Mild Traumatic Brain Injury: A Systematic Review and Meta‐Analysis

Acabchuk

Brisson

Park

et al. 2020

Applied Psych Health & Well

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“…Other reviews have been published previously on specific aspects of PCS. For example, recent reviews [ 75 , 76 , 77 ] focused on the effect of physical exercise in patients with persistent PCS and found that exercise significantly reduced the severity of PCS, the percentage of patients with PCS, and days off work, as compared to controls. Other recent reviews addressed issues such as interventions in sport-related concussion [ 17 , 78 ], reporting evidence in support of cervical rehabilitation, vestibulo-ocular rehabilitation, aerobic exercise, or rTMS [ 51 , 79 ], suggesting promising preliminary results for the treatment of post-concussive depression and headaches.…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review of Treatments of Post-Concussion Symptoms

Heslot

Azouvi

Perdrieau

et al. 2022

JCM

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Approximately 10–20% of patients who have sustained a mild Traumatic Brain Injury (mTBI) show persistent post-concussion symptoms (PCS). This review aims to summarize the level of evidence concerning interventions for PCS. Following the PRISMA guidelines, we conducted a systematic review regarding interventions for PCS post-mTBI until August 2021 using the Medline, Cochrane, and Embase databases. Inclusion criteria were the following: (1) intervention focusing on PCS after mTBI, (2) presence of a control group, and (3) adult patients (≥18 y.o). Quality assessment was determined using the Incog recommendation level, and the risk of bias was assessed using the revised Cochrane risk-of-bias tool. We first selected 104 full-text articles. Finally, 55 studies were retained, including 35 that obtained the highest level of evidence. The risk of bias was high in 22 out of 55 studies. Cognitive training, psycho-education, cognitive behavioral therapy, and graded return to physical activity demonstrated some effectiveness on persistent PCS. However, there is limited evidence of the beneficial effect of Methylphenidate. Oculomotor rehabilitation, light therapy, and headache management using repetitive transcranial magnetic stimulation seem effective regarding somatic complaints and sleep disorders. The preventive effect of early (<3 months) interventions remains up for debate. Despite its limitations, the results of the present review should encourage clinicians to propose a tailored treatment to patients according to the type and severity of PCS and could encourage further research with larger groups.

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“…For example, SRC patients with higher SES might benefit from additional psychoeducation and psychological treatment, as those patients have a higher risk for emotional disruption after SRC. In addition, specific subgroups of patients with persistent SRC might benefit from other existing and emerging treatments for persisting symptoms (e.g., cognitive behavioral therapy, graded exercise and cervical manual therapy) [41][42][43][44]. Future studies may provide valuable information on the role of prevailing symptoms in the efficiency of targeted treatment options for patient subgroups.…”

Section: Discussionmentioning

confidence: 99%

Heterogeneity of persisting symptoms after sport-related concussion (SRC): exploring symptom subtypes and patient subgroups

et al. 2022

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This study aimed to explore the heterogeneity of persisting symptoms after sport-related concussion (SRC). We examined the structure of symptom subtypes within 163 patients with SRC (M = 16.7 weeks post-injury). Subsequently, we investigated the existence of subgroups of patients based on comparable configuration of co-occurring symptom subtypes. To explore factors that may contribute to the emergence of SRC patient subgroups, subgroups were compared on pre-injury (i.e., demographics and medical history), personality (Severity Indices of Personality Problems Short Form) and SRC characteristics (i.e., history of prior concussions, loss of consciousness and post-traumatic amnesia). To investigate the relevance of SRC subgrouping for clinical outcome, subgroups were compared on symptom severity (Sport Concussion Assessment Tool 5). The results provide empirical evidence for the existence of symptom subtypes, characterized as a: neurocognitive, fatigue, emotional, migraine and vestibular-ocular symptom subtype in patients with persisting SRC. Study results also showed evidence for the existence of SRC subgroups of patients with a comparable configuration of co-occurring prevailing symptom subtypes, including a neurocognitive-migraine, fatigue, migraine-emotional and neurocognitive-emotional subgroup. The subgroups differed on pre-injury, personality and SRC characteristics, suggesting that these factors may contribute to the emergence of specific SRC patient subgroups. The subgroups also differed in the severity of persisting symptoms, highlighting the clinical relevance of SRC subgrouping. These results support the idea that patient subgroups with persisting SRC with a comparable pattern of co-occurring symptom subtypes exists, which may require targeted prognosis, clinical management and treatment to optimize recovery.

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Graded Combined Aerobic Resistance Exercise (CARE) to Prevent or Treat the Persistent Post-concussion Syndrome

Cited by 14 publications

References 97 publications

Therapeutic Effects of Meditation, Yoga, and Mindfulness‐Based Interventions for Chronic Symptoms of Mild Traumatic Brain Injury: A Systematic Review and Meta‐Analysis

Therapeutic Effects of Meditation, Yoga, and Mindfulness‐Based Interventions for Chronic Symptoms of Mild Traumatic Brain Injury: A Systematic Review and Meta‐Analysis

A Systematic Review of Treatments of Post-Concussion Symptoms

Heterogeneity of persisting symptoms after sport-related concussion (SRC): exploring symptom subtypes and patient subgroups

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