Early assessment of excess tolerance combined with performance on the King-Devick eye test to predict who may have a delayed recovery from (SRC) Sports Related Concussions.
About 1.6 to 3.8 million recreational and competitive American athletes develop a concussion each year. Therefore, it is important for health care professionals, especially neurologists, to keep up-to-date with the current guidelines and research. In fact, the American Academy of Neurology hosts a Sports Concussion Conference each year to ensure everyone is involved in the discussion of preventing, diagnosing, and managing sport-related concussion.
This year, we caught up with John Leddy, MD, from the University at Buffalo, after his session about returning to play after a sports-related concussion.1John J. Leddy, MD, is the medical director for the Concussion Management Clinic at the University at Buffalo in Buffalo, New York. Here are his answers to our burning questions.
NEUROLOGY CONSULTANT: Can you give us an overview of your session?
John Leddy: The title of my talk is “Return to activity and the role of exercise in sport-related concussion (SRC).” I spoke about the physiology of concussion—the role of the autonomic nervous system in concussion pathophysiology as well as the autonomic nervous system as a target for activity-based treatment. Then I reviewed the evidence supporting moderate levels of spontaneous physical activity during the acute phase after concussion and in patients with prolonged post-concussive symptoms (PPCS). The evidence shows that physical activity is either not harmful or is beneficial for both populations.
I then discussed the evidence for the use of physician-prescribed subsymptom threshold aerobic exercise to treat patients with PPCS and the emerging evidence that shows that exercise can safely shorten recovery from acute SRC and perhaps prevent some patients from experiencing a delayed recovery. I then reviewed the evidence from a cohort study of a dose-response relation to recovery between rest, placebo-stretching, and aerobic exercise, highlighting the difference in response between male and female athletes. Finally, I discussed the use of an early assessment of excess tolerance combined with performance on the King-Devick eye test to predict who may have a delayed recovery from SRC.