The Effect of ACTIVE Training on Clinical and Physiological Outcomes in Healthy and Concussed College-Aged Participants

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  • March 20, 2019
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  • Teel, Elizabeth
    • Affiliation: School of Medicine, Department of Allied Health Sciences, Curriculum in Human Movement Science
Abstract
  • Concussions are a pathophysiological injury resulting in symptom, clinical, and physiological deficits. Current guidelines dictate complete physical rest until asymptomatic but a shift towards more active recovery is being advised. Exercise as rehabilitation has been successful in patients with chronic concussion dysfunction, but has not been thoroughly studied acutely following injury. The expected changes of brief aerobic training on clinical and physiological outcomes remain unknown. The acute concussion therapy intervention (ACTIVE) training is an aerobic exercise program designed to expedite clinical and physiological healing following concussion, but first must be vetted in healthy populations. The primary purpose of this study was to evaluate the feasibility and effectiveness of ACTIVE training in healthy college-aged participants. Participants were randomly assigned to ACTIVE training or control groups. All participants received clinical and physiological assessments at two test sessions approximately 14 days apart. ACTIVE training participants completed six training bouts between test sessions. ACTIVE training was feasible, with no adverse events reported and high adherence to the progressively increasing training protocol. Heart rate (P=0.01), percentage of predicted maximal heart rate (P=0.01), and test duration (P=0.03) significantly increased in the intervention group between test sessions. The intervention group had significantly increased central alpha power between sessions and higher central theta compared to the control group (p=0.02) during eyes closed (p=0.006) conditions. Clinical outcomes were stable in response to ACTIVE training, with no mean differences exceeding reliable change scores. These cardiopulmonary improvements provide an important proof of concept in translating ACTIVE training to concussed patients, suggesting that aerobic training may target the physiological domains affected following concussion and help athletes maintain fitness during recovery. EEG outcomes may represent the neural underpinning of psychological and cognitive domains, which may have additional relevance to concussed populations and should be studied further in the future. The stability of clinical variables following ACTIVE training highlights their utility as diagnostic and management tools, as any changes seen in these assessments following injury represents subsequent healing and are not a byproduct of exercise alone.
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  • In Copyright
Advisor
  • Battaglini, Claudio L.
  • Appelbaum, Gregory
  • Register-Mihalik, Johna
  • Marshall, Stephen
  • Mihalik, Jason
  • Guskiewicz, Kevin M.
Degree
  • Doctor of Philosophy
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2017
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