Context: Prolonged physical and cognitive rest is a popular treatment approach for individuals with a concussion, however this prolonged inactivity has been found to exacerbate symptom reporting and prolong recovery.1,2 Research to counteract this phenomenon has utilized early post-concussion physical activity, from which promising results have emerged.3-5 However, researched physical activity protocols require heavy supervision and are not clinically feasible. Thus, identifying a different approach to track and promote early post-concussion physical activity is necessary. Purpose: The purpose of this study was to assess the relationship between post-concussion physical activity participation and two post-concussion recovery outcomes (symptom reporting and overall recovery time) in college-aged adults with a concussion. Methods: A prospective cohort study design was used to assess the relationship between post-concussion physical activity participation and concussion recovery outcomes. Participants were included if they completed their initial visit within 72 hours of concussion occurrence and were between 18-24 years old. Post-concussion physical activity was measured using an Actigraph GT9X Link Physical Activity Monitor and was expressed as Vector Magnitude (VM) counts per minute. Physical activity intensity was also evaluated and expressed as percent time spent in MVPA. Symptom reporting was represented as severity from visit 2, whereas, recovery time was the number of days from injury occurrence to medical clearance. A hierarchical multiple regression analysis was used to evaluate the relationship between VM counts per minute and symptom severity at visit 2 while controlling for participant sex and symptom severity at visit 1. Secondly, a linear regression analysis was used to evaluate the relationship between VM counts per minute and concussion recovery time. Exploratory hierarchical and linear regression analyses were also completed evaluating the relationship between percent time in MVPA and the recovery outcomes. Results: A total of 32 participants (male: 10, female: 22) completed testing and yielded valid post-concussion physical activity data. Participants averaged 2446 ± 441 VM counts per minute of physical activity, and spent 11.8% ± 3.7% of their time performing MVPA. Participants yielded symptom severities of 28 [24] and 2 [8] for visit 1 and visit 2, respectively. Average recovery time was 14.7±7.5 days. A significant hierarchical multiple regression model assessing the relationship between VM counts per minute and symptom reporting at visit 2 was found (F(2,28)=6.16, p=.002) and accounted for 39.8% of the variance (R2=.398). However, VM counts per minute did not significantly contribute to the model (B=-.006, 95% CI: -.015, .002, beta=-.239, p=.122). Likewise, VM counts per minute was not associated with concussion recovery time (B= -.003, 95% CI: -.010, .003, p=.276) and did not yield a significant regression model (F(1,30)=1.23, p=.276). Similar non-significant findings were found for the relationship between percent time in MVPA and symptom reporting (B = -.580, 95% CI: -1.59, .434, beta = -.180, p = .251) and recovery time (B = -.385, 95% CI: -1.129, .349, p = .292). Conclusion: Results from the current study suggest that simply increasing free-living physical activity participation throughout the day may not be enough to reduce post-concussion symptoms or shorten recovery time. Conversely, healthcare professionals should avoid broad statements simply telling patients to increase their activity levels as this may not provide enough guidance to optimize recovery. Conversely, clinicians recommending post-concussion physical activity should aim to provide more specific guidelines outlining physical active protocols that have previously been shown to improve concussion recovery.
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