A Randomized Controlled Trial Investigating the Feasibility and Adherence to an Aerobic Training Program in Healthy Individuals

in Journal of Sport Rehabilitation
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Context: Concussion management is moving from passive rest strategies to active interventions, including aerobic exercise therapy. Little information is available regarding the feasibility and adherence of these programs. Objectives: To determine whether an aerobic exercise training program intended for rehabilitation in people with concussion is feasible. Healthy, nonconcussed subjects were studied in this phase 1 trial. Design: Phase 1 parallel-group, randomized controlled trial in a sample of healthy (nonconcussed), recreationally active university students. Setting: Laboratory. Patients: 40 healthy university students. Methods: Participants were equally randomized to acute concussion therapy intervention (ACTIVE) training or nontraining groups. All participants completed maximal cardiopulmonary exercise tests on a stationary cycle ergometer at 2 test sessions approximately 14 days apart. During this 2-week study period, ACTIVE training participants completed six 30-minute cycling sessions, progressing from 60% to 80% of the participant’s individualized maximal oxygen consumption. A subset of participants (NACTIVE = 12, Nnontraining = 11) wore physical activity monitors throughout the 2-week study period. Main Outcomes Measures: Study protocol and randomization effectiveness, exercise safety and adherence, and progressive intensity of the ACTIVE training procedures. Results: No adverse events occurred during any exercise sessions. Twelve ACTIVE training participants (60%) completed all training sessions, and every participant completed at least 4 sessions. Heart rate increased throughout the training period (P < .001), but symptom changes and training adherence remained stable despite the progressively increasing workload. ACTIVE training participants completed approximately 30 additional minutes of physical activity on training sessions days, although that was not statistically significant (P = .20). Conclusions: University-aged students were adherent to the ACTIVE training protocol. Future research should investigate the safety and feasibility of aerobic training programs in acutely concussed individuals to determine their appropriateness as a clinical rehabilitation strategy.

Teel is with the School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada. Marshall is with Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC. Appelbaum is with Psychiatry and Behavioral Sciences, Duke University, Durham, NC. Battaglini is with Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC. Carneiro is with Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC. Guskiewicz and Register-Mihalik are with Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC. Mihalik is with the Department of Exercise and Sport Science, The University of North Carolina, Chapel Hill, NC.

Teel (elizabeth.teel@mail.mcgill.ca) is corresponding author.
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