Post-Concussion Aerobic Exercise

NCT ID: NCT04539509

Last Updated: 2023-12-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Clinical Phase

NA

Study Classification

INTERVENTIONAL

Study Start Date

2021-01-01

Study Completion Date

2024-12-31

Brief Summary

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This study is looking at the specific role of an exercise prescription on recovery from concussion symptoms in the general population.

Detailed Description

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435 people will participate in this study.

A physician will review a participant's medical history to determine if physical activity is appropriate for them. They will then be randomly assigned to 1 of 3 study groups:

1. Monitoring- participants will be given a heart rate monitor to wear on their wrist for the duration of the study (until "recovered", or until 8 weeks post-concussion, whatever comes first).
2. Monitoring + Treadmill Testing- in addition to wearing the heart rate monitor, they will undergo a treadmill test at each appointment.
3. Monitoring + Treadmill Testing + Specific Exercise Prescription- in addition to wearing the heart rate monitor, and treadmill test, they will receive an exercise prescription based on the results of the treadmill test.

The randomization is by chance. Participants have a 40/20/40% respective chance of being assigned to the study groups above. This means that out of every 5 people: 2 people will be assigned to the group 1, 1 will be assigned to the group 2, and 2 will be assigned to the group 3. Both participants and the study doctor will be aware which group participants are in.

Regardless of the group assigned, participants will receive an exercise prescription form at each appointment, as per usual care. The prescription will be based on the physician's judgement. If a participant is in group 3, their prescription will also take into account the results of the treadmill test.

Recovery will be determined using a 3-step approach:

1. Self-reported symptoms,
2. Clinic physician's opinion,
3. Treadmill test results (if applicable).

Conditions

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Concussion, Mild Mild Traumatic Brain Injury

Keywords

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Concussion Mild traumatic brain injury Aerobic exercise

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
The primary outcome (recovery) is determined using a 3 step approach. Each assessor responsible for one of the three steps, will be blind to at least ONE other recovery determinant.

Study Groups

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Monitoring

Participants will be given a heart rate monitor to wear on their wrist for the duration of the study (i.e. until recovered, or 8 weeks post-injury, whatever comes first).

Group Type ACTIVE_COMPARATOR

Monitoring

Intervention Type DEVICE

Activity monitoring using a Fitbit.

Monitoring + Treadmill Test

In addition to wearing the heart rate monitor, participants will undergo a treadmill test at each appointment.

Group Type PLACEBO_COMPARATOR

Treadmill Test

Intervention Type BEHAVIORAL

A symptom-limited treadmill test, using the Buffalo Concussion Treadmill Test (BCTT) protocol.

Monitoring

Intervention Type DEVICE

Activity monitoring using a Fitbit.

Monitoring + Treadmill Test + Specific Exercise Prescription

In addition to wearing the heart rate monitor, and completing a treadmill test at each appointment, participants will receive an exercise prescription based on the results of the treadmill test. They will be prescribed 30 minutes of structured aerobic exercise, 5 times per week, at a heart rate determined by their treadmill test.

Group Type EXPERIMENTAL

Exercise Prescription

Intervention Type BEHAVIORAL

A specific exercise prescription, based on the results of a treadmill test.

Treadmill Test

Intervention Type BEHAVIORAL

A symptom-limited treadmill test, using the Buffalo Concussion Treadmill Test (BCTT) protocol.

Monitoring

Intervention Type DEVICE

Activity monitoring using a Fitbit.

Interventions

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Exercise Prescription

A specific exercise prescription, based on the results of a treadmill test.

Intervention Type BEHAVIORAL

Treadmill Test

A symptom-limited treadmill test, using the Buffalo Concussion Treadmill Test (BCTT) protocol.

Intervention Type BEHAVIORAL

Monitoring

Activity monitoring using a Fitbit.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Patients that provide written informed consent prior to entry into the study
* Patients referred from the emergency department (ED) with recent (\<1 week) diagnosis of concussion by ED physician
* GCS score of 13-15 on presentation to the ED
* SCAT score \> 9 at week 1
* Physician cleared for exercise; low risk for cardiac disease (defined as no cardiopulmonary symptoms and meet no more than one risk factor for heart disease)
* Willing to exercise

Exclusion Criteria

* Evidence of intracranial hemorrhage, contusion or injury on brain imaging (CT Scan)
* Beta-blocker medication
* High dose (\>50mg/day) tricyclic antidepressant medication
* Pre-existing or current orthopedic injuries preventing exercise
* Pre-existing vestibular disease preventing exercise
* Heartrate increase \<30 bpm from rest on treadmill test
* Deemed asymptomatic from concussion by clinic physician
* Unable/unwilling to follow commands
Minimum Eligible Age

17 Years

Maximum Eligible Age

55 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Health Network, Toronto

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Mark Bayley, MD

Role: PRINCIPAL_INVESTIGATOR

University Health Network, Toronto Rehabilitation Institute

Locations

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Toronto Rehabilitation Institute - University Health Network

Toronto, Ontario, Canada

Site Status

Countries

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Canada

References

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Haider MN, Leddy JJ, Wilber CG, Viera KB, Bezherano I, Wilkins KJ, Miecznikowski JC, Willer BS. The Predictive Capacity of the Buffalo Concussion Treadmill Test After Sport-Related Concussion in Adolescents. Front Neurol. 2019 Apr 24;10:395. doi: 10.3389/fneur.2019.00395. eCollection 2019.

Reference Type BACKGROUND
PMID: 31105634 (View on PubMed)

Lawrence DW, Richards D, Comper P, Hutchison MG. Earlier time to aerobic exercise is associated with faster recovery following acute sport concussion. PLoS One. 2018 Apr 18;13(4):e0196062. doi: 10.1371/journal.pone.0196062. eCollection 2018.

Reference Type BACKGROUND
PMID: 29668716 (View on PubMed)

Leddy JJ, Willer B. Use of graded exercise testing in concussion and return-to-activity management. Curr Sports Med Rep. 2013 Nov-Dec;12(6):370-6. doi: 10.1249/JSR.0000000000000008.

Reference Type BACKGROUND
PMID: 24225521 (View on PubMed)

Other Identifiers

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15-9214

Identifier Type: OTHER

Identifier Source: secondary_id

20-5899

Identifier Type: -

Identifier Source: org_study_id