2023-06-14 バッファロー大学(UB)
◆適切な有酸素運動は、回復を促進し、持続性の症状を予防する効果があることが確認されている。これにより、休息だけではなく積極的な治療が重要視されるようになった。また、軽度の症状悪化は脳に悪影響を与えず、回復を遅らせないことも新たなガイドラインで示された。
<関連情報>
- https://www.buffalo.edu/news/releases/2023/06/Prescribed-exercise-after-sport-related-concussion-UB.html
- https://bjsm.bmj.com/content/57/12/762
スポーツ関連脳震盪後の早期の安静と運動:システマティックレビューとメタアナリシス Rest and exercise early after sport-related concussion: a systematic review and meta-analysis
John J Leddy,Joel S Burma,Clodagh M Toomey,Alix Hayden,Gavin A Davis,Franz E Babl,Isabelle Gagnon,Christopher C Giza,Brad G Kurowski,Noah D Silverberg,Barry Willer,Paul E Ronksley,Kathryn J Schneider
British Journal of Sports Medicine June 14, 2023
Abstract
Objective To synthesise the evidence regarding the risks and benefits of physical activity (PA), prescribed aerobic exercise treatment, rest, cognitive activity and sleep during the first 14 days after sport-related concussion (SRC).
Design Meta-analysis was performed for PA/prescribed exercise interventions and a narrative synthesis for rest, cognitive activity and sleep. Risk of bias (ROB) was determined using the Scottish Intercollegiate Guidelines Network and quality assessed using Grading of Recommendations, Assessment, Development and Evaluations.
Data sources MEDLINE, Embase, APA PsycInfo, Cochrane Central Register of Controlled Trials, CINAHL Plus and SPORTDiscus. Searches were conducted in October 2019 and updated in March 2022.
Eligibility criteria Original research articles with sport-related mechanism of injury in >50% of study sample and that evaluated how PA, prescribed exercise, rest, cognitive activity and/or sleep impact recovery following SRC. Reviews, conference proceedings, commentaries, editorials, case series, animal studies and articles published before 1 January 2001 were excluded.
Results 46 studies were included and 34 had acceptable/low ROB. Prescribed exercise was assessed in 21 studies, PA in 15 studies (6 PA/exercise studies also assessed cognitive activity), 2 assessed cognitive activity only and 9 assessed sleep. In a meta-analysis of seven studies, PA and prescribed exercise improved recovery by a mean of -4.64 days (95% CI -6.69, –2.59). After SRC, early return to light PA (initial 2 days), prescribed aerobic exercise treatment (days 2–14) and reduced screen use (initial 2 days) safely facilitate recovery. Early prescribed aerobic exercise also reduces delayed recovery, and sleep disturbance is associated with slower recovery.
Conclusion Early PA, prescribed aerobic exercise and reduced screen time are beneficial following SRC. Strict physical rest until symptom resolution is not effective, and sleep disturbance impairs recovery after SRC.
PROSPERO registration number CRD42020158928.
