The Effectiveness of Physical Therapy Interventions for Athletes Post-Concussion: A Systematic Review

Abstract

Background Sports-related concussions are the most common cause of head injury in adolescents and young adults. Typical treatment methods for this injury include cognitive and physical rest. Evidence suggests that physical activity and physical therapy interventions can be beneficial to decrease post-concussion symptoms. Purpose The aim of this systematic review was to investigate the effectiveness of physical therapy interventions for adolescent and young adult athletes post-concussion. Study Design Systematic Review Methods The following databases were utilized for the search: PubMed, CINAHL, Proquest, MEDLINE, SPORTDiscus, and SCOPUS. The search strategy focused on athletes, concussions, and physical therapy interventions. Data extraction from each article included: Authors, subjects, gender, mean age, age range, specific sport, acute or chronic concussion, first or recurrent concussion, treatments for intervention and control group, and outcomes measured. Results Eight studies met the inclusion criteria. Six of the eight articles scored seven or higher on the PEDro Scale. Physical therapy intervention(s), such as an aerobic intervention or a multimodal approach, show improvements in time to recovery and reduction of post-concussion symptoms in patients who have had a concussion. Physical activity and physical therapy as early as a couple days following injury, is beneficial at decreasing post-concussion symptoms, allows for earlier return to play, and/or shorter days to recovery, and is considered safe for treating post-concussion symptoms. Conclusion This systematic review demonstrates that physical therapy interventions including aerobic exercise and multimodal approaches have been found to be beneficial in treating adolescent and young adult athletes post-concussion. Utilizing aerobic or multimodal interventions for this population allows for a quicker symptom recovery and return to sport than traditional treatment of physical and cognitive rest. Future research should investigate the superior intervention for adolescents and young adults with post-concussion syndrome and determine if a single treatment or a multimodal approach is more beneficial.

A Critical Review of Existing Evidence-Based Sport Psychological Interventions for College Athletes with Comorbid Attention Deficit-Hyperactivity Disorder and Sport-Related Concussions

“…This skill has been proven to help student athletes with self-confidence and motor skill acquisition, which can be advantageous in performance enhancement (29). A recent systematic review concluded that mental imagery exercises improved postconcussion symptoms in athletes who sustained SRC (30). In this study, two RCTs were evaluated for their rehabilitative efficacy for acute and chronic symptoms of SRC and were found to decrease postconcussion symptoms (30).…”

“…A recent systematic review concluded that mental imagery exercises improved postconcussion symptoms in athletes who sustained SRC (30). In this study, two RCTs were evaluated for their rehabilitative efficacy for acute and chronic symptoms of SRC and were found to decrease postconcussion symptoms (30). This contradicts Arvinen-Barrow et al's (31) conclusions stating that the effectiveness of mental imagery during injury rehabilitation is indeterminate.…”

“…Recent evidence suggests that various mental skills training could be advantageous to assisting student-athletes with ADHD with the prevention, rehabilitation, and performance enhancement of SRC (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32). Mental skills are defined as the systematic development of cognitive and psychological abilities aimed at improving mental and sports performance (14)(15)(16).…”

Optimal Volume of Moderate-to-Vigorous Physical Activity Postconcussion in Children and Adolescents

“…Early engagement in physical activity has been associated with reduced symptom burden at 2 weeks postinjury, faster recovery, and a lower risk of developing PSAC. [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] However, the optimal volume of daily physical activity for achieving recovery in the general pediatric population remains unclear. 14 The reference standard protocol for identifying the optimal intensity of physical activity postconcussion is the Buffalo Concussion Treadmill Test.…”

“…PSAC significantly impairs daily activities and quality of life, underscoring the urgent need to generate and refine best evidence management protocols. Early engagement in physical activity has been associated with reduced symptom burden at 2 weeks postinjury, faster recovery, and a lower risk of developing PSAC . However, the optimal volume of daily physical activity for achieving recovery in the general pediatric population remains unclear …”