For over two decades, health experts believed that avoiding physical and mental activity and resorting to bed rest after a brain injury is the best path to recovery. However, a recent study has found that engaging in light exercise after a concussion helps in faster healing.

Exercise after a brain injury was avoided on the belief that it will slow down recovery and increase the chances of another concussion, which although rare, could pose serious complications and could be fatal.

These beliefs were overturned after researchers discovered that engaging in light physical and mental activities after the 24-48-hour recovery window of concussion would not harm as long as it does not worsen the symptoms. In 2017, international return-to-play guidelines for injured sportsmen were modified based on the viewpoint.

In the latest study, researchers from the University of Michigan monitored more than 1,200 college athletes at 30 institutions across the country.

They found the athletes who began doing light exercise within 48 hours of a concussion were more likely to resolve the symptoms than those who did not exercise. Their recovery time was about 2.5 days faster than others.

Athletes who started exercising later, after eight days or more after the injury, were less likely to experience symptom recovery. Even if they recover, they took about five days longer than those who started the exercise early.

The findings also suggest people who are likely to develop persistent concussion symptoms for more than four weeks are more likely to get benefit from the early start of exercise.

The researchers caution that the study does not mean getting back to play sooner but sticking to a progressive return-to-play approach. They also advise doing exercises under the supervision of a trained clinician.

"Based on the historical background, the adage 'the dosage makes the poison' applies to exercise after a concussion," said Landon Lempke, the first author of the study, adding that factors such as having "too much, too soon" or "too little, too late" can both be detrimental.

Although the researchers found a clear positive effect of exercise on the recovery period, they did not identify the type, duration or intensity of exercise that would help.

"For athletes, delaying or choosing not to report your concussion is directly tied to longer recovery as well as potential negative consequences. So reporting is the first step. For healthcare providers, it's important to stay current on concussion assessment and management practices. Clinicians still use 'cocoon therapy' despite known deleterious effects. Our present findings and many other studies indicate exercise can be started before symptoms resolve, if done in a safe and controlled manner as guided by a trained clinician," Lempke said.

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The athletes who do light exercise within 48 hours of a concussion are more likely to resolve the symptoms than those who do not exercise. Pixabay