Category: Brain Injury; Pediatric Rehabilitation
To investigate secondary neurocognitive and quality of life outcomes for a pilot randomized clinical trial (RCT) of aerobic training for management of prolonged symptoms after a mild traumatic brain injury (mTBI) in adolescents.
Secondary outcome analysis of a partially masked RCT of sub-symptom exacerbation aerobic training compared with a full-body stretching program highlighting cognitive and quality of life outcomes after 6 weeks of intervention.
Participants (or Animals, Specimens, Cadavers) :
Thirty adolescents ages 12 to 17 years who sustained a mTBI and had between 4 and 16 weeks of persistent post-concussive symptoms. 395 subjects were considered, 259 did not meet criteria, 102 declined participation, 4 withdrew during the study.
Sub-symptom exacerbation aerobic training compared with a full-body stretching program.
Main Outcome Measure(s) :
The outcomes assessed included neurocognitive changes in fluid and crystallized age-adjusted cognition using the National Institutes of Health (NIH) toolbox and self and parent-reported total quality of life using the Pediatric Quality of Life Inventory.
Results : Within group analyses using paired t-tests demonstrated improvement in age-adjusted fluid cognition (t(13)=3.39, p=0.005, Cohen’s d=0.61) and crystallized cognition (t(13)=2.63, p=0.02, Cohen’s d=0.70) within the aerobic training group but not within the stretching group. Paired t-tests demonstrated significant improvement in both self-reported and parent-reported total quality of life measures in the aerobic training group (self-report t(13)=3.51, p=0.004, Cohen’s d=0.94; parent-report t(13)=6.5, p
Quality of life improved significantly in both the aerobic exercise and stretching groups; however, this study suggests that only sub-symptom exacerbation aerobic training was potentially beneficial for neurocognitive recovery, particularly the fluid cognition subset in the NIH Toolbox.
Emily Gladstone– Resident Physician, Case Western Reserve-MetroHealth, Seven Hills, Ohio
Megan Narad– Assistant Professor, Cincinnati childrens hosoital medical center, Cincinnati, Ohio
Fadhil Hussain– Undergraduate Research Assistant, Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio
Jason Hugentobler– Physical Therapist, Cincinnati Children's Hospital Medical Center, cincinnati, Ohio
Catherine Quatman-Yates– Assistant Professor, The Ohio State University, Columbus, Ohio
Shari Wade– Professor, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
Paul Gubanich– Associate Professor, Sports Medicine Fellowship Director, Cincinnati Children's Hospital Medical Center, University of Cincinnati, South Lebanon, Ohio
Brad Kurowski– Associate Professor, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio