Matthew C Castellana, George J Burnett, Andrew Gasper, Muhammad S Z Nazir, John J Leddy, Christina L Master, Rebekah C Mannix, William P Meehan, Barry S Willer, Mohammad N Haider
{"title":"两项随机对照试验的二次分析显示，运动相关脑震荡后新发情绪症状较重的青少年可从规定的有氧运动中获益。","authors":"Matthew C Castellana, George J Burnett, Andrew Gasper, Muhammad S Z Nazir, John J Leddy, Christina L Master, Rebekah C Mannix, William P Meehan, Barry S Willer, Mohammad N Haider","doi":"10.1097/JSM.0000000000001242","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Approximately 20% of students with sport-related concussion (SRC) report new symptoms of anxiety and depression which may be associated with delayed recovery and increased risk for developing a mood disorder. Early prescribed aerobic exercise facilitates recovery in athletes with concussion-related exercise intolerance. We studied the effect of aerobic exercise treatment on new mood symptoms early after SRC.</p><p><strong>Design: </strong>Exploratory secondary analysis of 2 randomized controlled trials (RCT).</p><p><strong>Setting: </strong>Sports medicine clinics associated with UB (Buffalo, NY), CHOP (Philadelphia, PA), and Boston Children's Hospital (Boston, MA).</p><p><strong>Participants: </strong>Male and female adolescents (aged 13-18 years) diagnosed with SRC (2-10 days since injury).</p><p><strong>Interventions: </strong>Participants were randomized to individualized targeted heart rate aerobic exercise (n = 102) or to a placebo intervention designed to mimic relative rest (n = 96).</p><p><strong>Main outcome measures: </strong>Incidence of Persisting Post-Concussive Symptoms (PPCS, symptoms ≥28 days).</p><p><strong>Results: </strong>First RCT recruited from 2016 to 2018 and the second from 2018 to 2020. Of 198 adolescents, 156 (79%) reported a low burden (mean 1.2 ± 1.65/24) while 42 (21%) reported a high burden (mean 9.74 ± 3.70/24) of emotional symptoms before randomization. Intervention hazard ratio for developing PPCS for low burden was 0.767 (95% CI, 0.546-1.079; P = 0.128; β = 0.085) and for high burden was 0.290 (95% CI, 0.123-0.683; P = 0.005; β = 0.732).</p><p><strong>Conclusions: </strong>High burden of mood symptoms early after injury increases risk for PPCS, but the sports medicine model of providing early targeted aerobic exercise treatment reduces it. Nonsports medicine clinicians who treat patients with a high burden of new mood symptoms after concussion should consider prescribing aerobic exercise treatment to reduce the risk of PPCS and a mood disorder.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Adolescents With a High Burden of New-Onset Mood Symptoms After Sport-Related Concussion Benefit From Prescribed Aerobic Exercise, a Secondary Analysis of 2 Randomized Controlled Trials.\",\"authors\":\"Matthew C Castellana, George J Burnett, Andrew Gasper, Muhammad S Z Nazir, John J Leddy, Christina L Master, Rebekah C Mannix, William P Meehan, Barry S Willer, Mohammad N Haider\",\"doi\":\"10.1097/JSM.0000000000001242\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Approximately 20% of students with sport-related concussion (SRC) report new symptoms of anxiety and depression which may be associated with delayed recovery and increased risk for developing a mood disorder. Early prescribed aerobic exercise facilitates recovery in athletes with concussion-related exercise intolerance. We studied the effect of aerobic exercise treatment on new mood symptoms early after SRC.</p><p><strong>Design: </strong>Exploratory secondary analysis of 2 randomized controlled trials (RCT).</p><p><strong>Setting: </strong>Sports medicine clinics associated with UB (Buffalo, NY), CHOP (Philadelphia, PA), and Boston Children's Hospital (Boston, MA).</p><p><strong>Participants: </strong>Male and female adolescents (aged 13-18 years) diagnosed with SRC (2-10 days since injury).</p><p><strong>Interventions: </strong>Participants were randomized to individualized targeted heart rate aerobic exercise (n = 102) or to a placebo intervention designed to mimic relative rest (n = 96).</p><p><strong>Main outcome measures: </strong>Incidence of Persisting Post-Concussive Symptoms (PPCS, symptoms ≥28 days).</p><p><strong>Results: </strong>First RCT recruited from 2016 to 2018 and the second from 2018 to 2020. Of 198 adolescents, 156 (79%) reported a low burden (mean 1.2 ± 1.65/24) while 42 (21%) reported a high burden (mean 9.74 ± 3.70/24) of emotional symptoms before randomization. Intervention hazard ratio for developing PPCS for low burden was 0.767 (95% CI, 0.546-1.079; P = 0.128; β = 0.085) and for high burden was 0.290 (95% CI, 0.123-0.683; P = 0.005; β = 0.732).</p><p><strong>Conclusions: </strong>High burden of mood symptoms early after injury increases risk for PPCS, but the sports medicine model of providing early targeted aerobic exercise treatment reduces it. Nonsports medicine clinicians who treat patients with a high burden of new mood symptoms after concussion should consider prescribing aerobic exercise treatment to reduce the risk of PPCS and a mood disorder.</p>\",\"PeriodicalId\":10355,\"journal\":{\"name\":\"Clinical Journal of Sport Medicine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-07-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Journal of Sport Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/JSM.0000000000001242\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Journal of Sport Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/JSM.0000000000001242","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Adolescents With a High Burden of New-Onset Mood Symptoms After Sport-Related Concussion Benefit From Prescribed Aerobic Exercise, a Secondary Analysis of 2 Randomized Controlled Trials.
Objective: Approximately 20% of students with sport-related concussion (SRC) report new symptoms of anxiety and depression which may be associated with delayed recovery and increased risk for developing a mood disorder. Early prescribed aerobic exercise facilitates recovery in athletes with concussion-related exercise intolerance. We studied the effect of aerobic exercise treatment on new mood symptoms early after SRC.
Design: Exploratory secondary analysis of 2 randomized controlled trials (RCT).
Setting: Sports medicine clinics associated with UB (Buffalo, NY), CHOP (Philadelphia, PA), and Boston Children's Hospital (Boston, MA).
Participants: Male and female adolescents (aged 13-18 years) diagnosed with SRC (2-10 days since injury).
Interventions: Participants were randomized to individualized targeted heart rate aerobic exercise (n = 102) or to a placebo intervention designed to mimic relative rest (n = 96).
Main outcome measures: Incidence of Persisting Post-Concussive Symptoms (PPCS, symptoms ≥28 days).
Results: First RCT recruited from 2016 to 2018 and the second from 2018 to 2020. Of 198 adolescents, 156 (79%) reported a low burden (mean 1.2 ± 1.65/24) while 42 (21%) reported a high burden (mean 9.74 ± 3.70/24) of emotional symptoms before randomization. Intervention hazard ratio for developing PPCS for low burden was 0.767 (95% CI, 0.546-1.079; P = 0.128; β = 0.085) and for high burden was 0.290 (95% CI, 0.123-0.683; P = 0.005; β = 0.732).
Conclusions: High burden of mood symptoms early after injury increases risk for PPCS, but the sports medicine model of providing early targeted aerobic exercise treatment reduces it. Nonsports medicine clinicians who treat patients with a high burden of new mood symptoms after concussion should consider prescribing aerobic exercise treatment to reduce the risk of PPCS and a mood disorder.
期刊介绍：
Clinical Journal of Sport Medicine is an international refereed journal published for clinicians with a primary interest in sports medicine practice. The journal publishes original research and reviews covering diagnostics, therapeutics, and rehabilitation in healthy and physically challenged individuals of all ages and levels of sport and exercise participation.
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