Implementation of active injury management (AIM) in youth with acute concussion: A randomized controlled trial. Contemp Clin Trials 2022 Dec;123:106965
Date
10/18/2022Pubmed ID
36252936Pubmed Central ID
PMC10924688DOI
10.1016/j.cct.2022.106965Scopus ID
2-s2.0-85140490997 (requires institutional sign-in at Scopus site)Abstract
BACKGROUND: Nearly 2 million youth seek acute medical care following concussion in the U.S. each year. Current standard of care recommends rest for the first 48 h after a concussion. However, research suggests that prolonged rest may lengthen recovery time especially for patients with certain risk profiles. Research indicates that physical activity and behavioral management interventions (sleep, stress management) may enhance recovery. To date, there is limited empirical evidence to inform acute (<72 h) concussion recommendations for physical activity and behavioral management in adolescents.
OBJECTIVE: To determine the effectiveness of physical activity and behavioral management for acute concussion in adolescents and young adults, and to evaluate the role of patient characteristics on treatment response.
METHODS: This multicenter prospective randomized controlled trial will determine which combination of physical activity and behavioral management is most effective for patients 11-24 years old who present to the emergency department or concussion clinic within 72 h of injury. Participants are randomized into: 1) rest, 2) physical activity, 3) mobile health application (mHealth) behavioral management, or 4) physical activity and mHealth app conditions. Assessments at enrollment, 3-5 days, 14 days, 1 month, and 2 months include: concussion symptoms, balance, vestibular-ocular and cognitive assessments, quality of life, and recovery time. Somatic symptoms and other risk factors are evaluated at enrollment. Compliance with treatment and symptoms are assessed daily using actigraph and daily self-report. The primary study outcome is symptoms at 14 days.
CONCLUSION: Prescribed physical activity and behavioral management may improve outcomes in youth following acute concussion.
Author List
Thomas DG, Erpenbach H, Hickey RW, Waltzman D, Haarbauer-Krupa J, Nelson LD, Patterson CG, McCrea MA, Collins MW, Kontos APAuthors
Michael McCrea PhD Professor in the Neurosurgery department at Medical College of WisconsinLindsay D. Nelson PhD Associate Professor in the Neurosurgery department at Medical College of Wisconsin
Danny G. Thomas MD, MPH Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAdult
Brain Concussion
Child
Exercise
Humans
Post-Concussion Syndrome
Prospective Studies
Quality of Life
Young Adult
