Optimal Volume of Moderate-to-Vigorous Physical Activity Postconcussion in Children and Adolescents

• DOI: 10.1001/jamanetworkopen.2023.56458
• Publication Date: 2024-02-16T16:31:12Z
• Authors: Andrée-Anne Ledoux; Veronik Sicard; Vid Bijelić; Nick Barrowman; Michael M. Borghese; Nicholas Kuzik; Mark S. Tremblay; Keith Owen Yeates; Adrienne L. Davis; Gurinder Sangha; Nick Reed; Roger Leonard Zemek
• Keywords: Male; Canada; Adolescent; Cohort Studies; 03 medical and health sciences; 0302 clinical medicine; Linear Models; Humans; Female; Child; Exercise; Brain Concussion; Original Investigation

Importance Determining the optimal volume of early moderate-to-vigorous-intensity physical activity (MVPA) after concussion and its association with subsequent symptom burden is important for postinjury management recommendations. Objectives To investigate between cumulative MVPA (cMVPA) over 2 weeks at 1 week, weeks, 4 in children examine cMVPA odds persisting symptoms (PSAC) postinjury. Design, Setting, Participants This multicenter cohort study used data from a randomized clinical trial that was conducted March 2017 to December 2019 3 Canadian pediatric emergency departments participants aged 10.00 17.99 years acute less than 48 hours. Data were analyzed July 2022 2023. Exposure measured accelerometers worn on waist 24 hours per day 13 days postinjury, measurements deemed valid if had or more accelerometer fewer consecutive missing data. week defined as 7 respectively. Multiple imputations carried out days. Main Outcomes measures Self-reported postconcussion using Health Behavior Inventory (HBI). PSAC reliable change HBI. A linear mixed-effect model time × interaction. Logistic regressions assessed PSAC. All models adjusted prognostically variables. Results In this study, 267 456 (119 [44.6%] female; median [IQR] age, 12.9 [11.5 14.4] years) included analysis. greater significantly lower HBI scores (75th percentile [258.5 minutes] vs 25th [90.0 minutes]; difference, −5.45 [95% CI, −7.67 −3.24]) [565.0 [237.0 −2.85 −4.74 −0.97]) but not −1.24 −3.13 0.64]) ( P = .20). Symptom beyond 75th (1 259 minutes; 565 minutes) cMVPA. The ratio 0.48 (95% 0.24 0.94) weeks. Conclusions Relevance adolescents concussion, minutes during first second associated At higher 48% reduced compared volume.