PDF(Pubmed)
Abstract：
BACKGROUND: Recent scientific evidence has challenged the traditional \"rest-is-best\" approach for concussion management. It is now thought that \"exercise-is-medicine\" for concussion, owing to dozens of studies which demonstrate that sub-maximal, graded aerobic exercise can reduce symptom burden and time to symptom resolution. However, the primary neuropathology of concussion is altered functional brain activity. To date, no studies have examined the effects of sub-maximal aerobic exercise on resting state functional brain activity in pediatric concussion. In addition, although exercise is now more widely prescribed following concussion, its cardiopulmonary response is not yet well understood in this population. Our study has two main goals. The first is to understand whether there are exercise-induced resting state functional brain activity differences in children with concussion vs. healthy controls. The second is to profile the physiological response to exercise and understand whether it differs between groups.
METHODS: We will perform a single-center, controlled, prospective cohort study of pediatric concussion at a large, urban children\'s hospital and academic center. Children with sport-related concussion (aged 12-17 years) will be recruited within 4-weeks of injury by our clinical study team members. Key inclusion criteria include: medical clearance to exercise, no prior concussion or neurological history, and no implants that would preclude MRI. Age- and sex-matched healthy controls will be required to meet the same inclusion criteria and will be recruited through the community. The study will be performed over two visits separated by 24-48 h. Visit 1 involves exercise testing (following the current clinical standard for concussion) and breath-by-breath gas collection using a metabolic cart. Visit 2 involves two functional MRI (fMRI) scans interspersed by 10-minutes of treadmill walking at an intensity calibrated to Visit 1 findings. To address sub-objectives, all participants will be asked to self-report symptoms daily and wear a waist-worn tri-axial accelerometer for 28-days after Visit 2.
CONCLUSIONS: Our study will advance the growing exercise-concussion field by helping us understand whether exercise impacts outcomes beyond symptoms in pediatric concussion. We will also be able to profile the cardiopulmonary response to exercise, which may allow for further understanding (and eventual optimization) of exercise in concussion management.
BACKGROUND: Not applicable.
METHODS: We will perform a single-center, controlled, prospective cohort study of pediatric concussion at a large, urban children\'s hospital and academic center. Children with sport-related concussion (aged 12-17 years) will be recruited within 4-weeks of injury by our clinical study team members. Key inclusion criteria include: medical clearance to exercise, no prior concussion or neurological history, and no implants that would preclude MRI. Age- and sex-matched healthy controls will be required to meet the same inclusion criteria and will be recruited through the community. The study will be performed over two visits separated by 24-48 h. Visit 1 involves exercise testing (following the current clinical standard for concussion) and breath-by-breath gas collection using a metabolic cart. Visit 2 involves two functional MRI (fMRI) scans interspersed by 10-minutes of treadmill walking at an intensity calibrated to Visit 1 findings. To address sub-objectives, all participants will be asked to self-report symptoms daily and wear a waist-worn tri-axial accelerometer for 28-days after Visit 2.
CONCLUSIONS: Our study will advance the growing exercise-concussion field by helping us understand whether exercise impacts outcomes beyond symptoms in pediatric concussion. We will also be able to profile the cardiopulmonary response to exercise, which may allow for further understanding (and eventual optimization) of exercise in concussion management.
BACKGROUND: Not applicable.
摘要：
背景：最近的科学证据对脑震荡管理的传统“休息就是最好”方法提出了挑战。现在人们认为脑震荡的“运动就是医学”，由于数十项研究证明了次最大，分级有氧运动可以减少症状负担和症状解决时间。然而,脑震荡的主要神经病理学是脑功能活动的改变。迄今为止,尚未有研究检查亚最大有氧运动对小儿脑震荡患者静息状态功能性脑活动的影响.此外,尽管现在脑震荡后的运动规定更为广泛，在这一人群中，其心肺反应尚未得到很好的理解。我们的研究有两个主要目标。首先是了解脑震荡儿童与脑震荡儿童之间是否存在运动诱发的静息状态功能脑活动差异。健康的控制。第二个是分析对运动的生理反应，并了解不同群体之间是否存在差异。
方法：我们将执行单中心，控制,儿科脑震荡的前瞻性队列研究，城市儿童医院和学术中心。患有运动相关脑震荡的儿童（12-17岁）将在受伤后4周内由我们的临床研究小组成员招募。主要纳入标准包括：运动体检许可，之前没有脑震荡或神经病史,没有植入物会妨碍核磁共振成像.年龄和性别匹配的健康对照将被要求满足相同的纳入标准，并将通过社区招募。该研究将在间隔24-48小时的两次访问中进行。访问1涉及运动测试（遵循当前的脑震荡临床标准）和使用代谢推车的逐次呼吸气体收集。访视2包括两次功能性MRI（fMRI）扫描，穿插10分钟的跑步机行走，其强度校准为访视1的发现。为了解决次级目标，所有参与者将被要求每天自我报告症状,并在访视2后佩戴腰部佩戴的三轴加速度计28天.
结论：我们的研究将通过帮助我们了解运动对小儿脑震荡的影响是否超出症状，从而推进日益增长的运动脑震荡领域。我们还将能够描述心肺对运动的反应，这可能有助于进一步理解(并最终优化)脑震荡管理中的锻炼。
背景：不适用。
方法：我们将执行单中心，控制,儿科脑震荡的前瞻性队列研究，城市儿童医院和学术中心。患有运动相关脑震荡的儿童（12-17岁）将在受伤后4周内由我们的临床研究小组成员招募。主要纳入标准包括：运动体检许可，之前没有脑震荡或神经病史,没有植入物会妨碍核磁共振成像.年龄和性别匹配的健康对照将被要求满足相同的纳入标准，并将通过社区招募。该研究将在间隔24-48小时的两次访问中进行。访问1涉及运动测试（遵循当前的脑震荡临床标准）和使用代谢推车的逐次呼吸气体收集。访视2包括两次功能性MRI（fMRI）扫描，穿插10分钟的跑步机行走，其强度校准为访视1的发现。为了解决次级目标，所有参与者将被要求每天自我报告症状,并在访视2后佩戴腰部佩戴的三轴加速度计28天.
结论：我们的研究将通过帮助我们了解运动对小儿脑震荡的影响是否超出症状，从而推进日益增长的运动脑震荡领域。我们还将能够描述心肺对运动的反应，这可能有助于进一步理解(并最终优化)脑震荡管理中的锻炼。
背景：不适用。
