Effects of sub-symptom threshold aerobic exercise on persistent postconcussion symptom burden and exercise intolerance: a randomized controlled trial.
Lars-Johan V Valaas, Helene L Soberg, Mari S Rasmussen and 4 others
Structured aerobic exercise added to standard care did not reduce postconcussion symptoms more than standard care alone.
It did improve exercise tolerance at 12 weeks. Both groups improved in symptoms, mood, and fatigue over time.
Key findings
1SSTAE did not reduce postconcussion symptom burden more than standard care at 12 weeks or 6 months.
2SSTAE improved exercise tolerance (BCTT symptom threshold) more than standard care at 12 weeks, but the difference was no longer significant at 6 months.
3Both groups showed significant within-group improvements in symptom burden, quality of life, anxiety, depression, and fatigue over time.
Still to come
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Single center with one physical therapist delivering the intervention, which limits how far the results extend to other settings. Both groups received the treadmill test and were physically active during the trial, so the study cannot tell you what SSTAE does compared with a truly sedentary control. The sample ended up smaller than planned (81 instead of 96) because more patients than expected were already exercise-tolerant and were excluded, increasing the chance of missing a real effect. About 24 percent of eligible patients did not respond or declined, which may have selected for people more interested in physical activity. Patients could not be blinded to their group because the intervention is a structured exercise program. There is no established minimal clinically important difference for the BCTT symptom threshold, so the size of the exercise tolerance gain is hard to interpret clinically. Results may not generalize to children or older adults.
Declared interests
Funded by the Norwegian Fund for Post-Graduate Training in Physiotherapy. The funder had no role in trial design, conduct, data analysis, or reporting.
The easy way to misread this
Do not read the 12-week exercise tolerance gain as evidence that SSTAE reduces postconcussion symptoms. The primary outcome (symptom burden) showed no between-group difference at either time point, and the exercise tolerance advantage was no longer statistically significant at 6 months (P = .059).
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →