Early targeted heart rate exercise is safe and May hasten return-to-duty in service members with acute concussion, a preliminary study

ABSTRACT

Objective

To evaluate the feasibility of an exercise tolerance assessment and intervention added to the Progressive Return to Activity Clinical Recommendations (PRA-CR) in acutely concussed service members (SMs).

Methods

This non-randomized, pilot trial was performed at one center. SMs in the experimental group (ERG) performed the Buffalo Concussion March-in-place Test (BCMT) at every clinic visit and were prescribed at least 20 minutes/day of targeted exercise in addition to PRA-CR. Data for the control group (SCG) were extracted from the same clinic immediately prior to ERG. SMs in both groups were assessed by the same clinician to determine return-to-duty.

Results

BCMT identified concussion-related exercise intolerance in 100% (n = 14) at screening visit (mean 3.4 days after injury) and in 0% (n = 7) who had recovered. No adverse effects were associated with BCMT. The estimated recovery time for ERG who performed the exercise intervention (n = 12) was 17.0 (12.8, 21.2) days and for SCG (n = 15) was 23.7 (19.9, 27.5) days (p = 0.039).

Conclusion

Assessment of exercise tolerance was feasible and could be incorporated into the PRA-CR. Future definitive, randomized controlled trials should be performed to assess the effectiveness of exercise reset program for SMs after concussion.

KEYWORDS:

• Concussion
• service members
• persistent post concussive symptoms
• exercise reset
• Buffalo Concussion March-in-place Test

Acknowledgments

The authors would like to acknowledge Itai Bezherano, MD for developing the Buffalo Concussion March-in-place Test.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data is available on request from the authors at [email protected].

Disclaimer

The views expressed herein are those of the author(s) and do not necessarily reflect the official policy of the Department of the Army, Defense Health Agency, Department of Defense, or the US Government.

Supplemental data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/02699052.2024.2306334.

Additional information

Funding

This study is funded by the Department of Defense (DoD) Congressionally Directed Medical Research Program (CDRMP) planning grant PT180084 awarded to John J. Leddy.