Citation

Manikas V, Babl FE, Hearps SJ, Dooley J, Anderson V. J. Neurotrauma 2017; 34(11): 1932-1938.

Affiliation

University of Melbourne, 2281, Melbourne, Victoria, Australia ; vicki.anderson@rch.org.au.

Copyright

(Copyright © 2017, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2016.4762

PMID

28228043

Abstract

Recovery from concussion in childhood is poorly understood, despite its importance in decisions regarding return to normal activity. Resolution of post-concussive symptoms (PCS) is widely employed as a marker of recovery in clinical practice, however it is unclear if subtle impairments persist only to re-emerge in the context of increased physical or cognitive demands. This study aimed to examine the effect of strenuous exercise on clinical symptom report and neurocognition in children and adolescents after PCS resolution following concussion We recruited concussed children and adolescents (n=30) on presentation to an Emergency Department (ED). At Day 2 and Day 10 post self-reported symptom resolution, participants completed a strenuous exercise protocol, and pre- and post exercise assessment of PCS and neurocognition.

RESULTS demonstrated an overall reduction in PCS from Day 2 to Day 10 post-symptom resolution, with no evidence of symptom increase after strenuous exercise at either time point. Neurocognitive performance was linked to task complexity: on less cognitively demanding tasks processing speed was slower post-exercise and, unexpectedly, slower on Day 10 than Day while for more demanding tasks (new learning), Day 2 exercise resulted in faster responses, but Day 10 processing speed post-exercise was slower. In summary, we found the expected recovery pattern for PCS, 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.

FINDINGS provide some suggestion that premature return to normal activities (e.g., school) may slow neurocognitive recovery.

Language: en

Keywords

COGNITIVE FUNCTION; HEAD TRAUMA; OUTCOME MEASURES; PEDIATRIC BRAIN INJURY; RECOVERY