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Scand J Med Sci Sports. 2016 Mar;26(3):299-306. doi: 10.1111/sms.12441. Epub 2015 Mar 3.

A pilot study of active rehabilitation for adolescents who are slow to recover from sport-related concussion.

Gagnon I1,2,3, Grilli L2, Friedman D2,3,4, Iverson GL5,6,7,8.

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School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
Trauma Center, The Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada.
Department of Pediatrics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
Canadian Hospitals Injury Reporting and Prevention Program, Montreal, Quebec, Canada.
Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA.
Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA.
Mass General Hospital for Children Sports Concussion Program, Boston, Massachusetts, USA.
Red Sox Foundation and Massachusetts General Hospital Home Base Program, Boston, Massachusetts, USA.


The purpose of this study was to examine the effectiveness of an active rehabilitation intervention for adolescents who are slow-to-recover after a sport-related concussion. Ten adolescents (three girls and seven boys) seen at the Montreal Children's Hospital Concussion Clinic participated in this case series. Adolescents who were symptomatic more than 4 weeks after the injury were provided with an active rehabilitation intervention (M = 7.9 weeks following injury; range = 3.7 to 26.2 weeks). The rehabilitation program includes gradual, closely monitored light aerobic exercise, general coordination exercises, mental imagery, as well as reassurance, normalization of recovery, and stress/anxiety reduction strategies. The program continued until complete symptom resolution and readiness to begin stepwise return to activities. The primary outcome of the study was evolution of post-concussion symptoms. Secondary outcomes included mood, energy, balance, and cognition. After the intervention, post-concussion symptoms significantly decreased for the group of participants. They also had decreased fatigue and improved mood after 6 weeks of initiating the rehabilitation intervention. This case series shows that postconcussive symptoms and functioning in adolescents following sports-related concussion can be improved after participation in an active rehabilitation intervention. The introduction of graded light intensity exercise in the post-acute period following concussion is safe, feasible and appears to have a positive impact on adolescents' functioning.


Pediatric; aerobics; children; mild traumatic brain injury; physiotherapy; post-concussion symptoms; sports

[Indexed for MEDLINE]

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