Pilot Randomized Controlled Trial of an Exercise Program Requiring Minimal In-person Visits for Youth With Persistent Sport-Related Concussion
Objective: To evaluate feasibility and acceptability of a sub-threshold exercise program with minimal in-person visits to treat youth with persistent sport-related concussion, and explore efficacy for improving concussive symptoms, health-related quality of life, and fear-avoidance.Study design: We...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2019-06-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2019.00623/full |
| _version_ | 1818523268465819648 |
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| author | Sara P. D. Chrisman Sara P. D. Chrisman Sara P. D. Chrisman Kathryn B. Whitlock Jason A. Mendoza Jason A. Mendoza Monique S. Burton Monique S. Burton Ellie Somers Albert Hsu Lauren Fay Tonya M. Palermo Tonya M. Palermo Frederick P. Rivara Frederick P. Rivara Frederick P. Rivara |
| author_facet | Sara P. D. Chrisman Sara P. D. Chrisman Sara P. D. Chrisman Kathryn B. Whitlock Jason A. Mendoza Jason A. Mendoza Monique S. Burton Monique S. Burton Ellie Somers Albert Hsu Lauren Fay Tonya M. Palermo Tonya M. Palermo Frederick P. Rivara Frederick P. Rivara Frederick P. Rivara |
| author_sort | Sara P. D. Chrisman |
| collection | DOAJ |
| description | Objective: To evaluate feasibility and acceptability of a sub-threshold exercise program with minimal in-person visits to treat youth with persistent sport-related concussion, and explore efficacy for improving concussive symptoms, health-related quality of life, and fear-avoidance.Study design: We conducted a pilot randomized controlled trial comparing a 6 week sub-threshold exercise program requiring only two in-person visits to active control (stretching) for 12–18 year old youth with persistent sport-related concussion. We measured moderate-to-vigorous physical activity pre- and post-intervention using accelerometry, and increased goals weekly via phone contact. We examined feasibility and acceptability using qualitative interviews. We used exponential regression to model differences in trajectory of concussive symptoms by experimental group, and linear regression to model differences in trajectory of health-related quality of life and fear-avoidance of pain by experimental group.Results: Thirty-two subjects randomized, 30 completed the study (n = 11 control, n = 19 intervention), 57% female. Youth and parents reported enjoying participating in the study and appreciated the structure and support, as well as the minimal in-person visits. Exponential regression modeling indicated that concussive symptoms declined more rapidly in intervention youth than control (p = 0.02). Health-related quality of life and fear-avoidance of pain improved over time, but were not significantly different by group.Conclusions: This study indicates feasibility and potential benefit of a 6 week subthreshold exercise program with minimal in-person visits for youth with persistent concussion. Potential factors that may play a role in improvement such as fear-avoidance deserve further study. |
| first_indexed | 2024-12-11T05:43:00Z |
| format | Article |
| id | doaj.art-000b79d2f9ff4e51a8cce00e2aefce0b |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-11T05:43:00Z |
| publishDate | 2019-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-000b79d2f9ff4e51a8cce00e2aefce0b2022-12-22T01:19:04ZengFrontiers Media S.A.Frontiers in Neurology1664-22952019-06-011010.3389/fneur.2019.00623460069Pilot Randomized Controlled Trial of an Exercise Program Requiring Minimal In-person Visits for Youth With Persistent Sport-Related ConcussionSara P. D. Chrisman0Sara P. D. Chrisman1Sara P. D. Chrisman2Kathryn B. Whitlock3Jason A. Mendoza4Jason A. Mendoza5Monique S. Burton6Monique S. Burton7Ellie Somers8Albert Hsu9Lauren Fay10Tonya M. Palermo11Tonya M. Palermo12Frederick P. Rivara13Frederick P. Rivara14Frederick P. Rivara15Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, United StatesDepartment of Pediatrics, University of Washington, Seattle, WA, United StatesHarborview Injury Prevention and Research Center, Seattle, WA, United StatesCenter for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, United StatesCenter for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, United StatesDepartment of Pediatrics, University of Washington, Seattle, WA, United StatesDepartment of Pediatrics, University of Washington, Seattle, WA, United StatesDepartment of Orthopedics and Sports Medicine, Seattle Children's Hospital, Seattle, WA, United StatesDepartment of Sports Physical Therapy, Seattle Children's Hospital, Seattle, WA, United StatesCenter for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, United StatesCenter for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, United StatesCenter for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, United StatesDepartment of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, United StatesCenter for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, United StatesDepartment of Pediatrics, University of Washington, Seattle, WA, United StatesHarborview Injury Prevention and Research Center, Seattle, WA, United StatesObjective: To evaluate feasibility and acceptability of a sub-threshold exercise program with minimal in-person visits to treat youth with persistent sport-related concussion, and explore efficacy for improving concussive symptoms, health-related quality of life, and fear-avoidance.Study design: We conducted a pilot randomized controlled trial comparing a 6 week sub-threshold exercise program requiring only two in-person visits to active control (stretching) for 12–18 year old youth with persistent sport-related concussion. We measured moderate-to-vigorous physical activity pre- and post-intervention using accelerometry, and increased goals weekly via phone contact. We examined feasibility and acceptability using qualitative interviews. We used exponential regression to model differences in trajectory of concussive symptoms by experimental group, and linear regression to model differences in trajectory of health-related quality of life and fear-avoidance of pain by experimental group.Results: Thirty-two subjects randomized, 30 completed the study (n = 11 control, n = 19 intervention), 57% female. Youth and parents reported enjoying participating in the study and appreciated the structure and support, as well as the minimal in-person visits. Exponential regression modeling indicated that concussive symptoms declined more rapidly in intervention youth than control (p = 0.02). Health-related quality of life and fear-avoidance of pain improved over time, but were not significantly different by group.Conclusions: This study indicates feasibility and potential benefit of a 6 week subthreshold exercise program with minimal in-person visits for youth with persistent concussion. Potential factors that may play a role in improvement such as fear-avoidance deserve further study.https://www.frontiersin.org/article/10.3389/fneur.2019.00623/fullbrain concussionchildfear-avoidancepainexercisetraumatic brain injury |
| spellingShingle | Sara P. D. Chrisman Sara P. D. Chrisman Sara P. D. Chrisman Kathryn B. Whitlock Jason A. Mendoza Jason A. Mendoza Monique S. Burton Monique S. Burton Ellie Somers Albert Hsu Lauren Fay Tonya M. Palermo Tonya M. Palermo Frederick P. Rivara Frederick P. Rivara Frederick P. Rivara Pilot Randomized Controlled Trial of an Exercise Program Requiring Minimal In-person Visits for Youth With Persistent Sport-Related Concussion Frontiers in Neurology brain concussion child fear-avoidance pain exercise traumatic brain injury |
| title | Pilot Randomized Controlled Trial of an Exercise Program Requiring Minimal In-person Visits for Youth With Persistent Sport-Related Concussion |
| title_full | Pilot Randomized Controlled Trial of an Exercise Program Requiring Minimal In-person Visits for Youth With Persistent Sport-Related Concussion |
| title_fullStr | Pilot Randomized Controlled Trial of an Exercise Program Requiring Minimal In-person Visits for Youth With Persistent Sport-Related Concussion |
| title_full_unstemmed | Pilot Randomized Controlled Trial of an Exercise Program Requiring Minimal In-person Visits for Youth With Persistent Sport-Related Concussion |
| title_short | Pilot Randomized Controlled Trial of an Exercise Program Requiring Minimal In-person Visits for Youth With Persistent Sport-Related Concussion |
| title_sort | pilot randomized controlled trial of an exercise program requiring minimal in person visits for youth with persistent sport related concussion |
| topic | brain concussion child fear-avoidance pain exercise traumatic brain injury |
| url | https://www.frontiersin.org/article/10.3389/fneur.2019.00623/full |
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