Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Current Neurology and Neuroscience Reports
Erschienen in: Current Neurology and Neuroscience Reports 11/2018

01.11.2018 | Neurotrauma (D. Sandsmark, Section Editor)

Graded Combined Aerobic Resistance Exercise (CARE) to Prevent or Treat the Persistent Post-concussion Syndrome

verfasst von: Karen A. Sullivan, Andrew P. Hills, Grant L. Iverson

Erschienen in: Current Neurology and Neuroscience Reports | Ausgabe 11/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

To review the growing body of indirect and direct evidence that suggests that exercise can be helpful for children, adolescents, and adults with persistent symptoms following a mild traumatic brain injury (mTBI).

Recent Findings

The direct evidence shows that graded exercise assessments are safe, and that aerobic exercise interventions are associated with improvement of multiple symptoms and other benefits, including earlier return-to-sport. The indirect evidence supports this approach via studies that reveal the potential mechanisms, and show benefits for related presentations and individual symptoms, including headaches, neck pain, vestibular problems, sleep, stress, anxiety, and depression. We document the forms of exercise used for the post-acute management of mTBI, highlight the knowledge gaps, and provide future research directions.

Summary

We recommend trialing a new approach that utilizes a graduated program of individually prescribed combined aerobic resistance exercises (CARE) if mTBI symptoms persist. This program has the potential to improve patient outcomes and add to the management options for providers.
Literatur
1.
Dischinger PC, Ryb GE, Kufera JA, Auman KM. Early predictors of postconcussive syndrome in a population of trauma patients with mild traumatic brain injury. J Trauma. 2009;66:289–97.CrossRefPubMed
2.
Lundin A, de Boussard C, Edman G, Borg J. Symptoms and disability until 3 months after mild TBI. Brain Inj. 2006;20:799–806.CrossRefPubMed
3.
Cassidy JD, Cancelliere C, Carroll LJ, Cote P, Hincapie CA, Holm LW, et al. Systematic review of self-reported prognosis in adults after mild traumatic brain injury: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis. Arch Phys Med Rehabil. 2014;95:S132–51.CrossRefPubMed
4.
Yang CC, Hua MS, Tu YK, Huang SJ. Early clinical characteristics of patients with persistent post-concussion symptoms: a prospective study. Brain Inj. 2009;23:299–306.CrossRefPubMed
5.
Rutherford WH, Merrett JD, McDonald JR. Symptoms at one year following concussion from minor head injuries. Injury. 1979;10:225–30.CrossRefPubMed
6.
McLean SA, Kirsch NL, Tan-Schriner CU, Sen A, Frederiksen S, Harris RE, et al. Health status, not head injury, predicts concussion symptoms after minor injury. Am J Emerg Med. 2009;27:182–90.CrossRefPubMed
7.
Mickeviciene D, Schrader H, Obelieniene D, Surkiene D, Kunickas R, Stovner LJ, et al. A controlled prospective inception cohort study on the post-concussion syndrome outside the medicolegal context. Eur J Neurol. 2004;11:411–9.CrossRefPubMed
8.
Kraus J, Schaffer K, Ayers K, Stenehjem J, Shen H, Afifi AA. Physical complaints, medical service use, and social and employment changes following mild traumatic brain injury: a 6-month longitudinal study. J Head Trauma Rehabil. 2005;20:239–56.CrossRefPubMed
9.
Mansfield E, Stergiou-Kita M, Cassidy JD, Bayley M, Mantis S, Kristman V, et al. Return-to-work challenges following a work-related mild TBI: the injured worker perspective. Brain Inj. 2015;29:1362–9.CrossRefPubMed
10.
Kristman VL, Cote P, Hogg-Johnson S, Cassidy JD, Van Eerd D, Vidmar M, et al. The burden of work disability associated with mild traumatic brain injury in Ontario compensated workers: a prospective cohort study. The Open Occupational Health & Safety Journal. 2010;2:1–8.CrossRef
11.
Ruffolo CF, Friedland JF, Dawson DR, Colantonio A, Lindsay PH. Mild traumatic brain injury from motor vehicle accidents: factors associated with return to work. Arch Phys Med Rehabil. 1999;80:392–8.CrossRefPubMed
12.
Silverberg ND, Gardner AJ, Brubacher JR, Panenka WJ, Li JJ, Iverson GL. Systematic review of multivariable prognostic models for mild traumatic brain injury. J Neurotrauma. 2015;32:517–26.CrossRefPubMed
13.
Sean CR, Anastasia NF, Geoffrey LH. Physicians’ management practices and perceived health risks when postconcussion symptoms persist. Sports Health. 2015;8:37–42.
14.
Schneider KJ, Iverson GL, Emery CA, McCrory P, Herring SA, Meeuwisse WH. The effects of rest and treatment following sport-related concussion: a systematic review of the literature. Brit J Sport Med. 2013;47:304–7.CrossRef
15.
•• McCrory P, Meeuwisse W, Dvorak J, Aubry M, Bailes J, Broglio S, Cantu RC, Cassidy D, Echemendia RJ, Castellani RJ, Davis GA, Ellenbogen R, Emery C, Engebretsen L, Feddermann-Demont N, Giza CC, Guskiewicz KM, Herring S, Iverson GL, Johnston KM, Kissick J, Kutcher J, Leddy JJ, Maddocks D, Makdissi M, Manley G, McCrea M, Meehan WP, Nagahiro S, Patricios J, Putukian M, Schneider KJ, Sills A, Tator CH, Turner M, Vos PE. Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016 Br J Sports Med Published Online First: 2017. https://​doi.​org/​10.​1136/​bjsports-2017-097699 The most recent statement from the Concussion in Sport Group on the management of concussion that includes updated advice for graduated return to sport.
16.
Silverberg ND, Iverson GL. Is rest after concussion “the best medicine?”: recommendations for activity resumption following concussion in athletes, civilians, and military service members. J Head Trauma Rehabil. 2013;28:250–9.CrossRefPubMed
17.
Varner C, McLeod SL, Nahiddi N, Lougheed R. The influence of cognitive rest and graduated return to usual activities emergency department discharge instructions on symptoms of minor traumatic brain injury. Can J Emerg Med. 2016;18:S42.
18.
• Grabowski P, Wilson J, Walker A, Enz D, Wang S. Multimodal impairment-based physical therapy for the treatment of patients with post-concussion syndrome: a retrospective analysis on safety and feasibility. Phys Ther Sport. 2017;23:22–30. Although limited in terms of size and design, this study is one of only a handful that has utilized a multimodal approach to physical activity and rehabilitation to improve outcomes for people with persistent mTBI symptoms. CrossRefPubMed
19.
Kamins J, Giza CC. Concussion-mild traumatic brain injury: recoverable injury with potential for serious sequelae. Neurosurg Clin N Am. 2016;27:441–52.CrossRefPubMedPubMedCentral
20.
Craton N, Leslie O. Is rest the best intervention for concussion? Lessons learned from the whiplash model. Curr Sports Med Rep. 2014;13:201–4.CrossRefPubMed
21.
Iverson G, Silverberg ND, Mannix R, Maxwell BA, Atkins JE, Zafonte R, et al. Factors associated with concussion-like symptom reporting in high school athletes. JAMA Pediatr. 2015;169:1132–40.CrossRefPubMedPubMedCentral
22.
Garden N, Sullivan KA. An examination of the base rates of post-concussion symptoms: the influence of demographics and depression. Appl Neuropsychol. 2010;17:1–7.CrossRefPubMed
23.
Gagnon I, Galli C, Friedman D, Grilli L, Iverson GL. Active rehabilitation for children who are slow to recover following sport-related concussion. Brain Inj. 2009;23:956–64.CrossRefPubMed
24.
Nygren-de Boussard C, Holm LW, Cancelliere C, Godbolt AK, Boyle E, Stalnacke BM, et al. Nonsurgical interventions after mild traumatic brain injury: a systematic review. Results of the International Collaboration on Mild Traumatic Brain Injury Prognosis. Arch Phys Med Rehabil. 2014;95:S257–64.CrossRef
25.
Burke MJ, Fralick M, Nejatbakhsh N, Tartaglia MC, Tator CH. In search of evidence-based treatment for concussion: characteristics of current clinical trials. Brain Inj. 2015;29:300–5.CrossRefPubMed
26.
Wells EM, Goodkin HP, Griesbach GS. Challenges in determining the role of rest and exercise in the management of mild traumatic brain injury. J Child Neurol. 2016;31:86–92.CrossRefPubMed
27.
Mossberg KA, Amonette WE, Masel BE. Endurance training and cardiorespiratory conditioning after traumatic brain injury. J Head Trauma Rehabil. 2010;25:173–83.CrossRefPubMedPubMedCentral
28.
Devine JM, Zafonte RD. Physical exercise and cognitive recovery in acquired brain injury: a review of the literature. PM R. 2009;1:560–75.CrossRefPubMed
29.
Lojovich JM. The relationship between aerobic exercise and cognition: is movement medicinal? J Head Trauma Rehabil. 2010;25:184–92.CrossRefPubMed
30.
Hassett L, Moseley A, Harmer A. Fitness training for cardiorespiratory conditioning after traumatic brain injury. The Cochrane Database Syst Rev. 2017;12:Cd006123.PubMed
31.
Baker JG, Freitas MS, Leddy JJ, Kozlowski KF, Willer BS. Return to full functioning after graded exercise assessment and progressive exercise treatment of postconcussion syndrome. Rehabil Res Pract. 2012;2012:705309.PubMedPubMedCentral
32.
Vidal PG, Goodman AM, Colin A, Leddy JJ, Grady MF. Rehabilitation strategies for prolonged recovery in pediatric and adolescent concussion. Pediatr Ann. 2012;41:1–7.CrossRefPubMed
33.
Neeper SA, Gomez-Pinilla F, Choi J, Cotman C. Exercise and brain neurotrophins. Nature. 1995;373:109.CrossRefPubMed
34.
van Praag H. Neurogenesis and exercise: past and future directions. NeuroMolecular Med. 2008;10:128–40.CrossRefPubMed
35.
Griesbach GS, Sutton RL, Hovda DA, Ying Z, Gomez-Pinilla F. Controlled contusion injury alters molecular systems associated with cognitive performance. J Neurosci Res. 2009;87:795–805.CrossRefPubMedPubMedCentral
36.
Griesbach GS, Hovda DA, Molteni R, Wu A, Gomez-Pinilla F. Voluntary exercise following traumatic brain injury: brain-derived neurotrophic factor upregulation and recovery of function. Neuroscience. 2004;125:129–39.CrossRefPubMed
37.
Griesbach GS, Gomez-Pinilla F, Hovda DA. Time window for voluntary exercise-induced increases in hippocampal neuroplasticity molecules after traumatic brain injury is severity dependent. J Neurotrauma. 2007;24:1161–71.CrossRefPubMed
38.
Griesbach GS, Hovda DA, Gomez-Pinilla F, Sutton RL. Voluntary exercise or amphetamine treatment, but not the combination, increases hippocampal brain-derived neurotrophic factor and synapsin I following cortical contusion injury in rats. Neuroscience. 2008;154:530–40.CrossRefPubMedPubMedCentral
39.
Michelini LC, Stern JE. Exercise-induced neuronal plasticity in central autonomic networks: role in cardiovascular control. Exp Physiol. 2009;94:947–60.CrossRefPubMedPubMedCentral
40.
Szuhany KL, Bugatti M, Otto MW. A meta-analytic review of the effects of exercise on brain-derived neurotrophic factor. J Psychiatr Res. 2015;60:56–64.CrossRef
41.
Cotman CW, Berchtold NC, Christie L. Exercise builds brain health: key roles of growth factor cascades and inflammation. Trends Neurosci. 2007;30:464–72.CrossRefPubMed
42.
Schneider KJ, Meeuwisse WH, Nettel-Aguirre A, Barlow K, Boyd L, Kang J, et al. Cervicovestibular rehabilitation in sport-related concussion: a randomised controlled trial. Brit J Sport Med. 2014;48:1294–8.CrossRefPubMed
43.
Soderberg EI, Carlsson JY, Stener-Victorin E, Dahlof C. Subjective well-being in patients with chronic tension-type headache: effect of acupuncture, physical training, and relaxation training. Clin J Pain. 2011;27:448–56.CrossRefPubMed
44.
Lockett DM, Campbell JF. The effects of aerobic exercise on migraine. Headache. 1992;32:50–4.CrossRefPubMed
45.
Koseoglu E, Akboyraz A, Soyuer A, Ersoy AO. Aerobic exercise and plasma beta endorphin levels in patients with migrainous headache without aura. Cephalalgia. 2003;23:972–6.CrossRefPubMed
46.
Ahn AH. Why does increased exercise decrease migraine? Curr Pain Headache R. 2013;17:379.CrossRef
47.
Varkey E, Cider A, Carlsson J, Linde M. Exercise as migraine prophylaxis: a randomized study using relaxation and topiramate as controls. Cephalalgia. 2011;31:1428–38.CrossRefPubMedPubMedCentral
48.
Darabaneanu S, Overath CH, Rubin D, Luthje S, Sye W, Niederberger U, et al. Aerobic exercise as a therapy option for migraine: a pilot study. Int J Sports Med. 2011;32:455–60.CrossRefPubMed
49.
Molteni R, Ying Z, Gomez-Pinilla F. Differential effects of acute and chronic exercise on plasticity-related genes in the rat hippocampus revealed by microarray. Eur J Neurosci. 2002;16:1107–16.CrossRefPubMed
50.
Chaouloff F. Physical exercise and brain monoamines: a review. Acta Physiol Scand. 1989;137:1–13.CrossRefPubMed
51.
Wang C, Bannuru R, Ramel J, Kupelnick B, Scott T, Schmid CH. Tai Chi on psychological well-being: systematic review and meta-analysis. BMC Complem Altern M. 2010;10:23.CrossRef
52.
Herring MP, O’Connor PJ, Dishman RK. The effect of exercise training on anxiety symptoms among patients: a systematic review. Arch Intern Med. 2010;170:321–31.CrossRefPubMed
53.
Greenwood BN, Fleshner M. Exercise, learned helplessness, and the stress-resistant brain. NeuroMolecular Med. 2008;10:81–98.CrossRefPubMed
54.
Barbour KA, Edenfield TM, Blumenthal JA. Exercise as a treatment for depression and other psychiatric disorders: a review. J Cardpulm Rehabil. 2007;27:359–67.CrossRef
55.
Merom D, Phongsavan P, Wagner R, Chey T, Marnane C, Steel Z, et al. Promoting walking as an adjunct intervention to group cognitive behavioral therapy for anxiety disorders--a pilot group randomized trial. J Anxiety Disord. 2008;22:959–68.CrossRefPubMed
56.
Smits JA, Berry AC, Rosenfield D, Powers MB, Behar E, Otto MW. Reducing anxiety sensitivity with exercise. Depress Anxiety. 2008;25:689–99.CrossRefPubMed
57.
Stubbs B, Vancampfort D, Rosenbaum S, Firth J, Cosco T, Veronese N, et al. An examination of the anxiolytic effects of exercise for people with anxiety and stress-related disorders: a meta-analysis. Psychiatry Res. 2017;249:102–8.CrossRefPubMed
58.
Rejeski W, Pandya J, Miller M. Exercise and depressive symptoms: a comparison of aerobic and resistance exercise effects on emotional and physical function in older persons with high and low depressive symptomatology. J Gerontol B Psychol Sci Soc Sci. 2002;57:124–32.CrossRef
59.
Dunn AL, Trivedi MH, Kampert JB, Clark CG, Chambliss HO. Exercise treatment for depression: efficacy and dose response. Am J Prev Med. 2005;28:1–8.CrossRefPubMed
60.
Mead GE, Morley W, Campbell P, Greig CA, McMurdo M, Lawlor DA. Exercise for depression. Cochrane Database Syst Rev 2008:CD004366.
61.
Babyak M, Blumenthal JA, Herman S, Khatri P, Doraiswamy M, Moore K, et al. Exercise treatment for major depression: maintenance of therapeutic benefit at 10 months. Psychosom Med. 2000;62:633–8.CrossRefPubMed
62.
Lawlor DA, Hopker SW. The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials. Brit Med J. 2001;322:763–7.CrossRefPubMed
63.
Daley A. Exercise and depression: a review of reviews. J Clin Psychol Med S. 2008;15:140–7.CrossRef
64.
Mead GE, Morley W, Campbell P, Greig CA, McMurdo M, Lawlor DA. Exercise for depression. Cochrane Database Syst Rev 2009:CD004366.
65.
Rethorst CD, Wipfli BM, Landers DM. The antidepressive effects of exercise: a meta-analysis of randomized trials. Sports Med. 2009;39:491–511.CrossRefPubMed
66.
Wood CJ, Clow A, Hucklebridge F, Law R, Smyth N. Physical fitness and prior physical activity are both associated with less cortisol secretion during psychosocial stress. Anxiety Stress Coping. 2018;31:135–45.CrossRefPubMed
67.
Ekeland E, Heian F, Hagen KB, Abbott J, Nordheim L. Exercise to improve self-esteem in children and young people. Cochrane Db Syst Rev 2004:CD003683.
68.
Brand S, Beck J, Gerber M, Hatzinger M, Holsboer-Trachsler E. Football is good for your sleep’: favorable sleep patterns and psychological functioning of adolescent male intense football players compared to controls. J Health Psychol. 2009;14:1144–55.CrossRefPubMed
69.
Brand S, Gerber M, Beck J, Hatzinger M, Puhse U, Holsboer-Trachsler E. High exercise levels are related to favorable sleep patterns and psychological functioning in adolescents: a comparison of athletes and controls. J Adolesc Health. 2010;46:133–41.CrossRefPubMed
70.
71.
Cordingley D, Girardin R, Reimer K, Ritchie L, Leiter J, Russell K, et al. Graded aerobic treadmill testing in pediatric sports-related concussion: safety, clinical use, and patient outcomes. J Neuros-Pediatr. 2016;25:693–702.
72.
Hugentobler JA, Vegh M, Janiszewski B, Quatman-Yates C. Physical therapy intervention strategies for patients with prolonged mild traumatic brain injury symptoms: a case series. Int J Sports Phys Ther. 2015;10:676–89.PubMedPubMedCentral
73.
• Kurowski B, Hugentobler J, Quatman-Yates C, Taylor J, Gubanich P, Altaye M, et al. Aerobic exercise for adolescents with prolonged symptoms after mTBI: an exploratory RCT. J Head Trauma Rehabil. 2017;32:79–89. A small RCT for adolescents with mTBI symptoms that had persisted for up to 4 months. The trial compared outcomes for home-based programs involving aerobic exercise versus full body stretching. Symptom improvement was greatest with aerobic exercise, potentially showing that an aerobic component is needed.
74.
Maerlender A, Rieman W, Lichtenstein J, Condiracci C. Programmed physical exertion in recovery from sports-related concussion: a randomized pilot study. Dev Neuropsychol. 2015;40:273–8.CrossRefPubMed
75.
Majerske CW, Mihalik JP, Ren D, Collins MW, Reddy CC, Lovell MR, et al. Concussion in sports: postconcussive activity levels, symptoms, and neurocognitive performance. J Athl Train. 2008;43:265–74.CrossRefPubMedPubMedCentral
76.
• Clausen M, Pendergast DR, Willer B, Leddy J. Cerebral blood flow during treadmill exercise is a marker of physiological postconcussion syndrome in female athletes. J Head Trauma Rehabil. 2016;31:215–24. An important study that utilizes the concept of physiological post-concussion syndrome and shows the potential to map mechanistic brain changes in response to exercise for persistent mTBI symptoms. CrossRefPubMed
77.
Leddy JJ, Kozlowski K, Donnelly JP, Pendergast DR, Epstein LH, Willer B. A preliminary study of subsymptom threshold exercise training for refractory post-concussion syndrome. Clin J Sport Med. 2010;20:21–7.CrossRefPubMed
78.
•• Lal A, Kolakowsky-Hayner S, Ghajar J, Vazquez O, Balamane M. A systematic review and meta-analysis on the role of exercise or rest in patients with concussion and mild traumatic brain injury. Brit J Sport Med. 2017;51:A83-A. A high level of evidence study. It synthesized the findings from 14 studies, including 5 RCTS, and found promising effects on post-concussion symptoms for physical exercise-based interventions.
79.
Sawyer Q, Vesci B, McLeod TC. Physical activity and intermittent postconcussion symptoms after a period of symptom-limited physical and cognitive rest. J Athl Train. 2016;51:739–42.CrossRefPubMedPubMedCentral
80.
Cornelissen VA, Fagard RH, Coeckelberghs E, Vanhees L. Impact of resistance training on blood pressure and other cardiovascular risk factors: a meta-analysis of randomized, controlled trials. Hypertension. 2011;58:950–8.CrossRefPubMed
81.
Takeshima N, Rogers ME, Islam MM, Yamauchi T, Watanabe E, Okada A. Effect of concurrent aerobic and resistance circuit exercise training on fitness in older adults. Eur J Appl Physiol. 2004;93:173–82.CrossRefPubMed
82.
Riebe D, Ehrman JK, Liguori G, Magal M, the American College of Sports Medicine (ACSM). ACSM’s guidelines for exercise testing and prescription. 10th ed. Philadelphia, PA: Wolters Kluwer Health; 2018.
83.
Coetsee C, Terblanche E. Cerebral oxygenation during cortical activation: the differential influence of three exercise training modalities. A randomized controlled trial. Eur J Appl Physiol. 2017;117:1617–27.CrossRefPubMed
84.
Yarrow JF, White LJ, McCoy SC, Borst SE. Training augments resistance exercise induced elevation of circulating brain derived neurotrophic factor (BDNF). Neurosci Lett. 2010;479:161–5.CrossRefPubMed
85.
Church DD, Hoffman JR, Mangine GT, Jajtner AR, Townsend JR, Beyer KS, et al. Comparison of high-intensity vs. high-volume resistance training on the BDNF response to exercise. J Appl Physiol. 2016;121:123–8.CrossRefPubMed
86.
Aboagye E, Hagberg J, Axén I, Kwak L, Lohela-Karlsson M, Skillgate E, et al. Individual preferences for physical exercise as secondary prevention for non-specific low back pain: a discrete choice experiment. PLoS One. 2017;12:e0187709.CrossRefPubMedPubMedCentral
87.
Lacroix A, Kressig RW, Muehlbauer T, Gschwind YJ, Pfenninger B, Bruegger O, et al. Effects of a supervised versus an unsupervised combined balance and strength training program on balance and muscle power in healthy older adults: a randomized controlled trial. Gerontology. 2016;62:275–88.CrossRefPubMed
88.
Hills AP, Street SJ, Harris N. Getting Australia more active: challenges and opportunities for health promotion. Health Promot J Austr. 2014;25:30–4.CrossRefPubMed
89.
Hills AP, Street SJ, Byrne NM. Physical activity and health: “what is old is new again”. Adv Food Nutr Res. 2015;75:77–95.CrossRefPubMed
90.
Martin LR, Williams SL, Haskard KB, DiMatteo MR. The challenge of patient adherence. Ther Clin Risk Manag. 2005;1:189–99.PubMedPubMedCentral
91.
Daneshvar DH, Riley DO, Nowinski CJ, McKee AC, Stern RA, Cantu RC. Long-term consequences: effects on normal development profile after concussion. Phys Med Reh Clin N. 2011;22:683–700.CrossRef
92.
Centers for Disease Control and Prevention. Report to Congress on traumatic brain injury in the United States: epidemiology and rehabilitation. Atlanta, GA.2015.
93.
94.
Ardern CL, Taylor NF, Feller JA, Webster KE. A systematic review of the psychological factors associated with returning to sport following injury. Brit J Sport Med. 2013;47:1120–6.CrossRef
95.
Edmed SL, Sullivan KA. The influence of injury cause, contact-sport participation, and personal knowledge on expectation of outcome from mild traumatic brain injury. J Clin Exp Neuropsychol. 2014;36:221–35.CrossRefPubMed
96.
Blaine H, Sullivan KA, Edmed S. The effect of injury diagnosis on illness perceptions and expected postconcussion syndrome (PCS) and posttraumatic stress disorder (PTSD) symptoms. J Neurotrauma. 2013;30:1405–14.CrossRefPubMedPubMedCentral
97.
Borg GAV. Psychophysical based of perceived exertion. Med Sci Sports Exerc. 1982;14:377–81.PubMed
Metadaten
Titel
Graded Combined Aerobic Resistance Exercise (CARE) to Prevent or Treat the Persistent Post-concussion Syndrome
verfasst von
Karen A. Sullivan
Andrew P. Hills
Grant L. Iverson
Publikationsdatum
01.11.2018
Verlag
Springer US
Erschienen in
Current Neurology and Neuroscience Reports / Ausgabe 11/2018
Print ISSN: 1528-4042
Elektronische ISSN: 1534-6293
DOI
https://doi.org/10.1007/s11910-018-0884-9

Weitere Artikel der Ausgabe 11/2018

Current Neurology and Neuroscience Reports 11/2018 Zur Ausgabe

Pediatric Neurology (W Kaufmann, Section Editor)

The Gut Microbiota and Dysbiosis in Autism Spectrum Disorders

Pediatric Neurology (W Kaufmann, Section Editor)

Pediatric Multiple Sclerosis: an Update

Epilepsy (C Bazil, Section Editor)

Cannabis for the Treatment of Epilepsy: an Update

Stroke (H Diener, Section Editor)

Acute Treatment of Stroke (Except Thrombectomy)

Neurotrauma (D. Sandsmark, Section Editor)

Predicting Concussion Recovery in Children and Adolescents in the Emergency Department

Critical Care (S Mayer, Section Editor)

Fluid Management in Acute Brain Injury

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Kostenlos registrieren

Neu im Fachgebiet Neurologie

25.04.2024 | Hypotonie | Nachrichten

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

23.04.2024 | Demenz | Nachrichten

Demenzkranke durch Antipsychotika vielfach gefährdet

23.04.2024 | Parkinson-Krankheit | Podcast | Nachrichten

Parkinson-Therapie im Wandel – aktuelle Leitlinie im Fokus
Professorin Dr. Claudia Trenkwalder, Neurologin

22.04.2024 | DGIM 2024 | Nachrichten

Auf diese Krankheiten bei Geflüchteten sollten Sie vorbereitet sein
weitere anzeigen

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise