Stable recovery during and after 6-week aerobic exercise with limbs blood flow restriction and body cooling in post-concussion syndrome

Recent research has shown that exercise can improve post-concussion symptoms. It might be because exercise-induced human growth hormone enhances the brain function and recovery. Exercise under blood flow restriction (BFR) and cooling triggers physiologic responses at a relatively low intensity that might be beneficial to individuals with PCS and requires further investigation. Therefore, our ongoing study is to examine the outcomes of aerobic exercise with (experimental) or without (control) BFR and cooling. Twenty-three participants with PCS less than 1 year were randomly assigned to the control or the experimental groups. Both groups rode the recumbent bike (NuStep) for 30 minutes at 60% of the predicted heart rate while only the experimental group exercised under BFR and cooling (Vasper system) twice a week for 6 weeks followed by 6 weeks of no intervention. In addition to the aerobic exercise, each participant received the standardized physical therapy as part of the 6-week intervention. A post-concussion Symptoms/Signs checklist was filled daily by the participant for 12 weeks. To examine the symptoms fluctuations, the variances of checklist scores for each participant during the intervention period and over the 6 weeks of no intervention were calculated. Mann-Whitney U test showed that variability of the overall symptom severity was significantly less in the experimental group (p = 0.01) during the intervention period, and the overall concussion load remained significantly stable in the experimental group (p = 0.02) after the intervention ended. These preliminary results have demonstrated that aerobic exercise with BFR and cooling enhances the recovery of PCS. Aerobic exercise alleviated the post-concussion symptoms of individuals with PCS less than 1 year. More stable recovery was found in the individuals who exercised at 60% of predicted maximum heart rate under BFR and body cooling as compared to the individuals without body cooling and BFR.

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