Citation

Bezherano I, Haider MN, Willer BS, Leddy JJ. Clin. J. Sport. Med. 2020; ePub(ePub): ePub.

Affiliation

UBMD Department of Orthopedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York.

Copyright

(Copyright © 2020, Canadian Academy of Sport Medicine, Publisher Lippincott Williams and Wilkins)

DOI

10.1097/JSM.0000000000000809

PMID

32058454

Abstract

Exercise intolerance is an objective biomarker of the physiological dysfunction after sport-related concussion (SRC). Several trials have established the safety and clinical efficacy of subsymptom threshold aerobic exercise prescribed within 1 week of injury as treatment for SRC. Clinicians, however, may not be comfortable prescribing aerobic exercise after SRC. This article presents 3 methods of exercise prescription for patients with SRC. The first requires a graded exertion test plus a home-based exercise program requiring a heart rate (HR) monitor. The second requires a graded exertion test but no HR monitor for home-based exercise. The third requires solely an HR monitor to safely progress through the home-based exercise prescription. Patients are encouraged to keep a symptom and exercise diary and return for re-evaluation every 1 to 2 weeks. Delayed recovery should prompt the clinician to evaluate for other potential symptom generators (eg, cervical, vestibular, oculomotor, mood, or migraine disorders).

Language: en