{"id":8073,"date":"2023-03-16T15:28:47","date_gmt":"2023-03-16T12:28:47","guid":{"rendered":"https:\/\/gfmg.ua\/new\/?p=8073"},"modified":"2023-03-23T16:11:39","modified_gmt":"2023-03-23T13:11:39","slug":"likuvannja-strusu-mozku","status":"publish","type":"post","link":"https:\/\/gfmg.ua\/en\/likuvannja-strusu-mozku\/","title":{"rendered":"Physical activity, as an aid in treating concussions"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"8073\" class=\"elementor elementor-8073\" data-elementor-post-type=\"post\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-22c9c5d elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no\" data-id=\"22c9c5d\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div 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elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no\" data-id=\"e07b0c5\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-124c630\" data-id=\"124c630\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-a2826aa elementor-widget__width-auto elementor-widget elementor-widget-heading\" data-id=\"a2826aa\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">ARTICLE<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d3a5aa4 elementor-widget elementor-widget-theme-post-title elementor-page-title elementor-widget-heading\" data-id=\"d3a5aa4\" data-element_type=\"widget\" data-widget_type=\"theme-post-title.default\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\"><a href=\"\">Physical activity, as an aid in treating concussions<\/a><\/h1>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-35c4b70 elementor-reverse-mobile elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no\" data-id=\"35c4b70\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-3c6a49b\" data-id=\"3c6a49b\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-9e3c538 elementor-widget elementor-widget-heading\" data-id=\"9e3c538\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Clinical Context\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-7db3aba elementor-reverse-mobile elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no\" data-id=\"7db3aba\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-9036cc2\" data-id=\"9036cc2\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-f8b2d72 elementor-widget elementor-widget-heading\" data-id=\"f8b2d72\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">Sports-related concussion (SRC) is a significant public health problem for which there is currently no effective treatment, with up to 30% of children and adolescents still having symptoms 1 month after injury. Because exercise can worsen postconcussive symptoms, return of normal exercise tolerance helps determine physiological readiness to resume sports activities.\n\n<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7197e53 elementor-widget elementor-widget-heading\" data-id=\"7197e53\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">Although the standard of care for SRC has been rest until symptoms resolve, some studies have shown lack of harm and possible benefit of self-selected moderate levels of physical activity or prescribed aerobic exercise for patients with delayed recovery. <\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-74d4a38 elementor-widget elementor-widget-heading\" data-id=\"74d4a38\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">The goal of this randomized clinical trial was to compare the efficacy of aerobic exercise below the symptom threshold with that of a placebo-like stretching program for adolescents in the acute phase of SRC recovery.\n\n<\/p>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-d7583a3\" data-id=\"d7583a3\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-30b4a6b elementor-widget elementor-widget-image\" data-id=\"30b4a6b\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"560\" height=\"340\" src=\"https:\/\/gfmg.ua\/wp-content\/uploads\/2023\/03\/LikuvannjaStrusuMozku.jpg\" class=\"attachment-large size-large wp-image-8066\" alt=\"\" srcset=\"https:\/\/gfmg.ua\/wp-content\/uploads\/2023\/03\/LikuvannjaStrusuMozku.jpg 560w, https:\/\/gfmg.ua\/wp-content\/uploads\/2023\/03\/LikuvannjaStrusuMozku-64x39.jpg 64w, https:\/\/gfmg.ua\/wp-content\/uploads\/2023\/03\/LikuvannjaStrusuMozku-300x182.jpg 300w\" sizes=\"(max-width: 560px) 100vw, 560px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-4a87755 elementor-reverse-mobile elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no\" data-id=\"4a87755\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-56a49e5\" data-id=\"56a49e5\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-c0085db elementor-widget elementor-widget-heading\" data-id=\"c0085db\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Study Synopsis and Perspective\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e9f7aaf elementor-widget elementor-widget-heading\" data-id=\"e9f7aaf\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">Contrary to traditional recommendations for prolonged, prescribed rest after a SRC, new research suggests that a regimen of low-level aerobic exercise may speed recovery and reduce symptoms.\n\n<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-493facc elementor-widget elementor-widget-heading\" data-id=\"493facc\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">In a randomized clinical trial, researchers assessed 103 adolescents within 1 week of experiencing a concussion. Those assigned to aerobic exercise recovered after a median of 13 days compared with 17 days for those assigned to a placebo-like stretching regimen, which translated into a statistically significant difference.\n\n<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3d3ea27 elementor-widget elementor-widget-heading\" data-id=\"3d3ea27\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">\"I'm a team doctor. We had athletes who were not recovering in a typical timeframe, so we came up with this idea of using subthreshold exercise to help them recover,\" principal investigator John J. Leddy, MD, from UBMD Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, told Medscape Medical News.\n\n\"That was in people with prolonged symptoms, and it worked,\" he said.\n\nThe findings were published online February 4 in JAMA Pediatrics.<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fc8275d elementor-widget elementor-widget-heading\" data-id=\"fc8275d\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Questioning \"Rest Is Best\"\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c1baeaa elementor-widget elementor-widget-heading\" data-id=\"c1baeaa\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">Historically, clinicians instructed youth experiencing SRCs to rest until all symptoms resolved.\n\n\"That's fine for the 75% to 80% of people who recover normally, within a week or 2,\" Dr Leddy said. \"But what about those who don't? Do you just tell them to keep resting and wait until it goes away?\"\n\nHe said the investigators also questioned the strength of evidence behind the \"rest-is-best approach,\" noting it is based on animal research and consensus guidelines.\n\nThe current multicenter study builds on the findings of a prior \"small, uncontrolled initial foray into using subthreshold exercise to treat adult patients with prolonged symptoms, people who were experiencing postconcussion symptoms for weeks or months,\" Dr Leddy said.<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7aa8d49 elementor-widget elementor-widget-heading\" data-id=\"7aa8d49\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">\"In the last 10 years, there have been more and more studies, either observational or with prescribed exercise, showing that in fact, not only is it not harmful, it may be beneficial,\" he added.\n\nHowever, \"to move the field, you need to do randomized clinical trials,\" he said.\n\nThe investigators randomly assigned male and female athletes aged 13 to 18 years to either subthreshold aerobic exercise (n=52) or a stretching regimen (n=51). An experienced sports medicine physician diagnosed the concussions using International Concussion in Sport Group criteria.<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9f58388 elementor-widget elementor-widget-heading\" data-id=\"9f58388\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">\"We started working with adolescents because it soon become clear that they take longer to recover than other groups,\" Dr Leddy said. \"Nobody really knows why that is.\"\n\nParticipants were recruited from September 2015 to June 2018. The baseline evaluation included a cognitive assessment and completion of a concussion symptom questionnaire. Participants also underwent a standard physical exam and a graded exercise tolerance assessment, using the Buffalo Concussion Treadmill Test.\n\nThis assessment allowed researchers to determine an individualized 80% threshold for aerobic exercise based on the participant's heart rate. Participants repeated the BCTT weekly up to 30 days.<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-986848f elementor-widget elementor-widget-heading\" data-id=\"986848f\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Quicker Recovery\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8c8261a elementor-widget elementor-widget-heading\" data-id=\"8c8261a\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">The aerobic exercise group wore heart rate sensors and fitness trackers to monitor their heart rates. They were instructed to perform daily exercise on a stationary bike or a treadmill at home or in a gym, under supervision.\n\nEach session lasted 20 minutes or until their symptoms increased 2 points or more on a 10-point visual analog scale, at which point they stopped. The investigators also told them to rest otherwise, and not to play any contact sports or participate in gym class or team practice.<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-bce20b8 elementor-widget elementor-widget-heading\" data-id=\"bce20b8\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">The stretching group also wore heart rate monitors during each session. They received the same instructions about resting otherwise. Both groups received the same amount of attention.\n\nThe aerobic exercise group recovered in a median of 13 days (interquartile range [IQR], 10-18.5 days) vs 17 days (IQR, 13-23 days) for the stretching group (P=.009).\n\nThere was a protective trend against athletes developing delayed recovery in the aerobic exercise group. \"[T]his was a potentially crucial outcome, given the burden of social and academic problems during prolonged recovery in this age group,\" the researchers write.<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f22fc84 elementor-widget elementor-widget-heading\" data-id=\"f22fc84\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">Participants reported symptoms online each evening between 7 and 10 pm, using the Post-Concussion Symptom Scale. There was no significant difference between groups regarding compliance: 83.8% of the exercise group and 86.6% of the stretching group completed daily symptom reports (P=.16).\n\nThe trial lasted 30 days, after which any athlete still experiencing symptoms received interdisciplinary treatment. This delayed-recovery group included 2 participants in the exercise group and 7 in the stretching cohort.<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c490f92 elementor-widget elementor-widget-heading\" data-id=\"c490f92\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">There were no adverse events in the study, although 1 participant was \"a near miss,\" the researchers report. This athlete became \"severely symptomatic\" on the BCTT and decided to withdraw from the study before randomization.<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-07795ac elementor-widget elementor-widget-heading\" data-id=\"07795ac\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Confidence Booster\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-26c7678 elementor-widget elementor-widget-heading\" data-id=\"26c7678\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">\"The results of this study should give clinicians confidence that moderate levels of physical activity, including prescribed subsymptom threshold aerobic exercise, after the first 48 hours following [SRC,] can safely and significantly speed recovery,\" the investigators write.\n\nThe researchers caution that the findings should not be generalized to younger children, adults with risk factors for heart disease, or patients with non-sports-related concussions. They also emphasize the importance of carefully monitoring exercise, so patients do not exceed their individual threshold for exacerbating concussion symptoms.<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-de327ce elementor-widget elementor-widget-heading\" data-id=\"de327ce\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">\"This is not equivalent to a return to sport-specific play; rather, it is an early active intervention intended to improve recovery to the point where it is safe for the athlete to begin the graduated process of returning to his or her sport,\" the investigators note.\n\nWhy aerobic exercise might work remains unknown. \"We think exercise actually restores control to the autonomic nervous system, which is clearly affected by concussion,\" Dr Leddy said. Aerobic exercise could help increase blood flow to the muscles, brain, or both, he added.<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1457a92 elementor-widget elementor-widget-heading\" data-id=\"1457a92\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">Increased neuroplasticity is another possibility. Exercise may increase brain-derived neurotrophic factor, which repairs neurons and promotes hippocampal growth, he said.\n\n\"Exercise has several [beneficial] effects, but again we need to prove that,\" Dr Leddy added.<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ae74f30 elementor-widget elementor-widget-heading\" data-id=\"ae74f30\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Paradigm Shift?\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7e6956d elementor-widget elementor-widget-heading\" data-id=\"7e6956d\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">\"Early on there was a hefty amount of skepticism\" about whether aerobic exercise postconcussion could be effective, Dr Leddy said. \"I think the skepticism has come down now.\"\n\nSeveral professional medical societies recently stopped endorsing the \"rest is best\" for everyone strategy. For example, such a consensus emerged from the 5th International Conference on Concussion in Sport.\n\nAs reported by Medscape Medical News, the Centers for Disease Control and Prevention recently included this perspective in its evidence-based guidelines.<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-65561e7 elementor-widget elementor-widget-heading\" data-id=\"65561e7\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">In addition, the American Academy of Pediatrics updated its guidance on SRCs in a statement that describes the evolution from elimination of all activity in the days after a concussion to an emphasis on reduction of activity.\n\n\"You have to find the sweet spot between not doing something other than lying in a dark room under the covers and going back to full participation in sports,\" Dr Leddy said. \"The trick is really finding that sweet spot.\"<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-81d8875 elementor-widget elementor-widget-heading\" data-id=\"81d8875\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">Dr Leddy and colleagues are now doing a larger study in collaboration with Harvard University and the University of Pennsylvania. They will report results on an intent-to-treat analysis, \"which is more how medicine is practiced in real life vs in a research setting,\" he said.\n\nThe participants in the next study will have more accurate heart rate monitors. One goal is to try to determine the minimal dose of exercise that confers postconcussion benefits.<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-dadf7a3 elementor-widget elementor-widget-heading\" data-id=\"dadf7a3\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">\"Landmark Study\"\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-feb5c1c elementor-widget elementor-widget-heading\" data-id=\"feb5c1c\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">\"Research on exercise and concussion has been in transition, and this is a landmark study that may shift the standard of care toward the use of rehabilitative exercise to decrease the duration of concussion symptoms,\" Sara P.D. Chrisman, MD, from the Department of Pediatrics, University of Washington, and the Harborview Injury Prevention and Research Center in Seattle, writes in an accompanying editorial.\n\nDr Chrisman also notes some study limitations. The researchers excluded adolescents with depression, anxiety, and attention-deficit\/hyperactivity disorder out of concern that such diagnoses were associated with greater risk for persistent concussive symptoms.<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f1fbc60 elementor-widget elementor-widget-heading\" data-id=\"f1fbc60\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">\"However, these diagnoses are also particularly prevalent in youth seen for concussion, and not including them means we cannot draw conclusions regarding whether aerobic exercise is an effective treatment for youth with concussions who exhibit mental health symptoms, or whether we should instead specifically target mental health interventions in these individuals, as has been done in previous studies,\" she writes.\n\n<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-40166be elementor-widget elementor-widget-heading\" data-id=\"40166be\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">The researchers also did not measure physical activity in an objective way, and \"thus it is impossible to estimate the dose of exercise required to elicit a treatment outcome.\"\n\nFuture research, she adds, could address some unanswered questions. For example, what is the earliest timeframe postconcussion to start exercise safely? Is it possible for patients to exercise too frequently or too intensely, and if so, what are the risks? Is exercise beneficial for all patients postconcussion?<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b394538 elementor-widget elementor-widget-heading\" data-id=\"b394538\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">\"We look forward to following this line of research as it propels us toward continued improvement in the management of concussion,\" Dr Chrisman writes.<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0c4b7bd elementor-widget elementor-widget-heading\" data-id=\"0c4b7bd\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">The study was funded by grants from the National Institute of Neurological Disorders and Stroke and the National Center for Advancing Translational Sciences. Dr Leddy and Dr Chrisman have reported no relevant financial relationships.\n\n<\/p>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-15e88eb elementor-widget elementor-widget-heading\" data-id=\"15e88eb\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">JAMA Pediatr. Published online February 4, 2019.\n\n<\/p>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-d33f9ef elementor-reverse-mobile elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no\" data-id=\"d33f9ef\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-c449f08\" data-id=\"c449f08\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-74271ec elementor-align-right btn_ico elementor-widget elementor-widget-button\" data-id=\"74271ec\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-md\" href=\"https:\/\/www.medscape.org\/viewarticle\/911140\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"38\" height=\"8\" viewBox=\"0 0 38 8\" fill=\"none\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M37.028 4.20659C37.413 4.02711 37.413 3.47974 37.028 3.30026L30.053 0.0482401C29.6553 -0.137218 29.2286 0.243158 29.3674 0.65952L29.9487 2.40332C29.9655 2.45363 29.9782 2.50511 29.9867 2.55727L0 2.55727L0 4.55728L29.9895 4.55728C29.9827 4.60402 29.9726 4.65028 29.9592 4.6957L29.3133 6.88686C29.1915 7.29984 29.6139 7.66334 30.0042 7.4814L37.028 4.20659Z\" fill=\"white\"><\/path><\/svg>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Reposted from 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