Effect Of Exercise On Patients With Concussion: 1530 Board #205 June 1 9

PURPOSE: To examine the effect of exercise prescription on days from injury to symptom resolution and on days from first clinic visit to symptom resolution among youth with sports-related concussions presenting to a concussion clinic. METHODS: Data were retrospectively analyzed using electronic health records from seven concussion clinics at a pediatric hospital in the Midwest. Patients aged 10-17 years with a sports-related concussion (SRC) who presented to the clinics within 30 days post-injury, from May 2015 to May 2016 were included in the study. Youth in the exercise prescription group were prescribed non-contact exercise before symptom resolution while youth in the comparison group were prescribed exercise at or after symptom resolution. Unadjusted and adjusted generalized linear regression models were used to model the effect of active exercise prescription on days to symptom resolution, adjusting for age, sex, history of previous concussion, days from injury to initial visit, and symptom score at time of injury. RESULTS: Of 357 (male=229, female=128) concussed youth included, 204 (57.1%) were in the exercise prescription group and 153 (42.9%) were in the comparison group. The median symptom score (SS) at injury was 37 [interquartile range (IQR): 29.5] for the exercise prescription group and 36 (IQR: 32.0) for the comparison group. No statistically significant differences were observed in SS at injury (p=0.4719), SS at initial clinic visit (p=0.4146), or days from injury to initial clinic visit between the two groups (p=0.3725). The median of symptom resolution for youth in the exercise prescription group was 16 days, which was statistically significantly longer than youth in the comparison group (median=12 days, p=0.0192) after adjusting for other covariates. However, no statistically significantly difference was found in days from first clinic visit to symptom resolution between the two groups (p = 0.1118). CONCLUSIONS: Prescription of exercise during recovery from concussion did not shorten the duration of symptoms from time of injury, however it did not lengthen the time to recover from concussion when measured from the first physician visit. Further research with prospective design is warranted to evaluate the effect of non-contact exercise prescription on concussion recovery among youth.