Exercise May Be a Better Concussion Treatment Than Rest

Concussions are a common outcome of car accidents and falls, making them a frequent feature in workers compensation claims and personal injury suits. Current wisdom is that there is no treatment for a concussion besides physical and mental rest, but a 2018 study published in Current Sports Medicine Reports suggests a different option.

Rest—from both physical exertion and mentally taxing activities—is recommended after sustaining a concussion because exertion exacerbates symptoms. Symptoms of a concussion may include:

  • Balance issues
  • Confusion
  • A headache
  • Irritability
  • Nausea and vomiting
  • Short-term memory impairment
  • Sleep problems

However, this study suggests that light exercise—exercise that stops before the subject reaches exhaustion or experiences a flare-up of concussion symptoms—may aid in recovery from a concussion.

What the Data Suggests

The researchers looked at data from treadmill and stationary bicycle fitness tests for people who have had concussions. They used this data to establish a baseline heart rate—different for everyone—below which concussion symptoms did not appear.

After this baseline was established, the patients were prescribed exercise for 20 minutes a day. They were instructed to keep their heart rate at 80 to 90 percent of the baseline heart rate.

The researchers then reviewed the literature on rest versus this type of light physical activity. They found that, by and large, subthreshold exercise was more effective in returning patients’ physiological measurements to normal faster.

The metric studies were arterial carbon dioxide (PaCO2), an elevated level of which is a sign of a concussion. When PaCO2 levels are high, blood flows to the brain too quickly, which aggravates concussion symptoms. The data in this study suggests that light exercise can lower PaCO2 levels faster than rest after a concussion.

Exercise as Medicine

The authors of this study conclude that a personalized program for light exercise can be an effective treatment for long-term concussion symptoms. “Individualized aerobic exercise is a nonpharmaceutical intervention that challenges the old paradigm of prolonged rest, has minimal adverse effects, can be implemented with standard equipment, and could be used at many physician offices and health facilities, including military facilities and in the field, with relative ease,” they wrote.

Read the full study here.