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Latest Clinical Research Published by ACSM.

Aerobic Exercise for Sports-related Concussion: A Systematic Review and Meta-analysis The return-to-play guidelines for sports-related concussion (SRC) continue to evolve. The First International Consensus Statement from Vienna in 2001 recommended “no activity and complete rest” until asymptomatic, while the Third International Consensus Statement from Zurich in 2008 recommended “complete physical and cognitive rest until symptoms resolve.” However, the most recent guidelines from Berlin (2016) state that there is “insufficient evidence” for complete rest and suggests a gradual resumption of physical activity starting 24 to 48 h after an SRC. This systematic review and meta-analysis from Quebec, published in the December 2020 issue of Medicine & Science in Sports & Exercise® (MSSE), critically analyzes the research that compares post-SRC protocols that include early resumption of physical activity to protocols that do not allow any physical activity until complete resolution of all SRC-related symptoms (1). Studies considered for inclusion were randomized controlled trials involving individuals who sustained an SRC and were randomized to an aerobic exercise group or a control group that did not exercise until complete symptom resolution. Adjunct interventions, such as cognitive activation, coordination, or balance exercises, were allowed in either group. Studies were categorized by the timing of the exercise intervention, either “acute stage” (less than 4 wk from the concussion) or “persistent symptom stage” (≥4wk from the SRC). The intensity of the exercise (light, moderate, or vigorous) alsowas noted when possible. The primary outcome for the analysis was symptom intensity. Other outcomes were time-to-recovery, balance, cognitive capacity, and adverse events. Each study was assessed for risk of bias (RoB) using the 13 criterion of the Cochrane risk of bias tool, and categorized as low RoB, high RoB, or unclear RoB. Statistical heterogeneity also was calculated. The overall quality of the summarized evidence was assessed by the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach,