Over the years the treatment of sports-related concussions has really changed. It used to be that the person was told to rest in a darkened room for several days, but lately research has been suggesting the opposite.
A recent study found that after receiving a sports-related concussion, it is beneficial to engage in one 20 minute aerobic exercise 5 to 14 days after the injury (concussion). The aerobic exercise was only at 80% heart rate threshold (the threshold associated with symptoms worsening and/or exhaustion. In other words, it was an aerobic exercise that wasn't too vigorous, and only for 20 minutes. In the study they cycled on recumbent bikes.
In the small study (16 participants between 8-24 years, all varsity athletes), the exercise didn't make symptoms worse. In fact, it helped with their thinking (executive functioning of the brain) and improved concussion symptoms in the early stages of recovery. This may be due to increased blood flow and oxygen to the brain from moving about.
From Medical Xpress: Concussed athletes' brains benefit from just 20 minutes of exercise
In a new study, Western researchers have shown just one 20-minute session of moderate intensity aerobic exercise can improve an athlete's executive function and concussion symptoms in the early stages of recovery.
Executive function is essential for everyday tasks, from remembering a grocery list to making strategic decisions in sports. When a basketball player closely guarded by an opponent holds back from shooting, opting to pass the ball to a teammate instead, they're tapping into the brain's inhibitory control—an important aspect of executive function. But a sports-related concussion can disrupt executive function, impacting on-field performance.
"Executive function is an underlying feature of high-level cognitive control," said Matthew Heath, professor and faculty scholar in the School of Kinesiology at Western and senior author of the paper. "One of the most persistent symptoms or deficits associated with a sports-related concussion is an impairment in executive function, resulting in difficulties making quick on-field decisions."
Now, Western researchers have discovered a promising way to help athletes bounce back. The findings, published in the Journal of Sports Sciences, underscore the positive effects of aerobic exercise on a concussed athlete's executive function.
"When athletes with sports-related concussions engaged in aerobic exercise below their symptom threshold, we found their executive function, which is the ability to multitask, to plan things and to inhibit or withhold impulsive responses, improved," said Alma Rahimi, first author of the paper and a Schulich School of Medicine & Dentistry graduate with a master's in neuroscience.
Researchers conducted the study with 16 Western varsity athletes in the early stages of concussion recovery, spanning three to 14 days post-injury. The athletes were compared to a control group of 16 athletes who had not experienced a concussion.
The concussed athletes first completed a task to assess their executive function, then exercised for 20 minutes at their sub-symptom threshold, identified by determining their heart rate at 80% of where concussion symptoms began to worsen. After the exercise, participants repeated the executive function task.
Evaluating their performance pre- and post-exercise revealed the workout decreased the amount of time required for concussed athletes to complete the task, said Rahimi, who is now a clinical psychology master's and Ph.D. student at the University of Toronto.
"We measured athletes' executive function before as well as after the exercise and found they had shorter reaction times, indicating that exercise improves executive function. The fact that a 20-minute bout of exercise could lead to improved cognition is very exciting."
In addition to improvements in executive function following exercise, the study also noted a reduction in the severity and frequency of concussion symptoms. When researchers followed up with study participants 24 hours later, they found symptoms such as headaches, nausea and dizziness also improved.
These findings suggest executive function benefits are also closely tied to the alleviation of concussions symptoms, Heath said, which may be in part due to increased blood flow to the brain.
Understanding how the brain responds to a single session of exercise after a concussion is a major step forward in aiding the recovery of athletes with sports-related concussions. It also reinforces that the traditional approach of prescribing cognitive and physical rest should no longer be the standard.
"Athletes don't have to seclude themselves in a dark room," said Rahimi. "They can walk, get on a bike or anything that allows them to increase their heart rate and activate their muscles, ensuring they don't further injure themselves or exacerbate their symptoms."
Identifying that threshold where athletes benefit from improved executive function without exacerbating their symptoms is key. This is where clinical kinesiologists can play a vital role, prescribing appropriate exercise intensity and duration tailored to an athlete's post-concussion recovery needs, Heath said.
In severe cases, the researchers found some athletes never fully recover from deficits in their executive function. Currently, there are limited guidelines available to support athletes dealing with these ongoing challenges.
That's why the researchers believe these findings are essential for advancing the understanding of sports-related concussions. This growing knowledge is expected to pave the way for more effective strategies to help athletes recover and return to peak performance.