Management of persistent postconcussion symptoms in youth: a randomised control trial protocol
IntroductionCurrent management of concussion consists of early education, rest until symptom free, with gradual return to school and physical activity protocols. Although this management strategy is effective for most youth who sustain a concussion, it is not an appropriate strategy for youth with p...
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| Veröffentlicht in: | BMJ open 2015-07, Vol.5 (7), p.e008468-e008468 |
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| creator | Reed, Nick Greenspoon, Dayna Iverson, Grant L DeMatteo, Carol Fait, Philippe Gauvin-Lepage, Jérôme Hunt, Anne Gagnon, Isabelle J |
| description | IntroductionCurrent management of concussion consists of early education, rest until symptom free, with gradual return to school and physical activity protocols. Although this management strategy is effective for most youth who sustain a concussion, it is not an appropriate strategy for youth with persistent postconcussion symptoms. Prolonged rest and periods of restricted activity may place youth at risk for secondary issues and contribute to the chronicity of postconcussion symptoms. The purpose of this study is to evaluate the efficacy of an active rehabilitation protocol for youth who are slow to recover from concussion. It is hypothesised that an active rehabilitation intervention can reduce persistent postconcussion symptoms, improve function and facilitate return to activity. This article describes the research protocol.Methods and analysisThis is a randomised clinical trial with blinded outcome measurement. Participants will be recruited and randomly assigned to 1 of 2 treatment groups, an active rehabilitation intervention or a standard care education group. Both groups will receive standard care education. However, the active rehabilitation group will participate in an additional low-intensity exercise programme consisting of aerobic, coordination and visualisation exercises. Both the active rehabilitation and the standard care education interventions will be 6 weeks in duration. The primary outcome measure is postconcussion symptoms. Secondary outcome measures include functional recovery (cognitive, motor, psychosocial and emotional functioning) and return to activity. Outcome measures will be administered preintervention and postintervention. The primary outcome measure will also be repeated 2 weeks into the intervention period.Ethics and disseminationThis study has been approved by the Holland Bloorview Kids Rehabilitation Hospital research ethics board (REB # 13-459). The findings from this study will be shared with the general public, sport associations, relevant brain injury organisations and healthcare professionals.Trial registration numberNCT02257749. |
| doi_str_mv | 10.1136/bmjopen-2015-008468 |
| format | Article |
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Although this management strategy is effective for most youth who sustain a concussion, it is not an appropriate strategy for youth with persistent postconcussion symptoms. Prolonged rest and periods of restricted activity may place youth at risk for secondary issues and contribute to the chronicity of postconcussion symptoms. The purpose of this study is to evaluate the efficacy of an active rehabilitation protocol for youth who are slow to recover from concussion. It is hypothesised that an active rehabilitation intervention can reduce persistent postconcussion symptoms, improve function and facilitate return to activity. This article describes the research protocol.Methods and analysisThis is a randomised clinical trial with blinded outcome measurement. Participants will be recruited and randomly assigned to 1 of 2 treatment groups, an active rehabilitation intervention or a standard care education group. Both groups will receive standard care education. However, the active rehabilitation group will participate in an additional low-intensity exercise programme consisting of aerobic, coordination and visualisation exercises. Both the active rehabilitation and the standard care education interventions will be 6 weeks in duration. The primary outcome measure is postconcussion symptoms. Secondary outcome measures include functional recovery (cognitive, motor, psychosocial and emotional functioning) and return to activity. Outcome measures will be administered preintervention and postintervention. The primary outcome measure will also be repeated 2 weeks into the intervention period.Ethics and disseminationThis study has been approved by the Holland Bloorview Kids Rehabilitation Hospital research ethics board (REB # 13-459). The findings from this study will be shared with the general public, sport associations, relevant brain injury organisations and healthcare professionals.Trial registration numberNCT02257749.</description><identifier>ISSN: 2044-6055</identifier><identifier>EISSN: 2044-6055</identifier><identifier>DOI: 10.1136/bmjopen-2015-008468</identifier><identifier>PMID: 26231756</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Adolescent ; Brain Concussion - complications ; Child ; Children & youth ; Concussion ; Consent ; Exercise ; Exercise - physiology ; Exercise Therapy ; Female ; Heart Rate ; Humans ; Intervention ; Male ; Mental health ; Participation ; Patient Compliance ; Patient Education as Topic ; Post-Concussion Syndrome - etiology ; Post-Concussion Syndrome - rehabilitation ; Psychomotor Performance - physiology ; Recovery of Function ; Rehabilitation ; Research Design ; Self Care ; Single-Blind Method ; Sports and Exercise Medicine ; Teenagers</subject><ispartof>BMJ open, 2015-07, Vol.5 (7), p.e008468-e008468</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions 2015 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b472t-a20be35753ec5b4a2bf2d6e34b7893f394f56a110af0adfb0c18ea28778794013</citedby><cites>FETCH-LOGICAL-b472t-a20be35753ec5b4a2bf2d6e34b7893f394f56a110af0adfb0c18ea28778794013</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://bmjopen.bmj.com/content/5/7/e008468.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttp://bmjopen.bmj.com/content/5/7/e008468.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27549,27550,27924,27925,53791,53793,77601,77632</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26231756$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Reed, Nick</creatorcontrib><creatorcontrib>Greenspoon, Dayna</creatorcontrib><creatorcontrib>Iverson, Grant L</creatorcontrib><creatorcontrib>DeMatteo, Carol</creatorcontrib><creatorcontrib>Fait, Philippe</creatorcontrib><creatorcontrib>Gauvin-Lepage, Jérôme</creatorcontrib><creatorcontrib>Hunt, Anne</creatorcontrib><creatorcontrib>Gagnon, Isabelle J</creatorcontrib><title>Management of persistent postconcussion symptoms in youth: a randomised control trial protocol</title><title>BMJ open</title><addtitle>BMJ Open</addtitle><description>IntroductionCurrent management of concussion consists of early education, rest until symptom free, with gradual return to school and physical activity protocols. Although this management strategy is effective for most youth who sustain a concussion, it is not an appropriate strategy for youth with persistent postconcussion symptoms. Prolonged rest and periods of restricted activity may place youth at risk for secondary issues and contribute to the chronicity of postconcussion symptoms. The purpose of this study is to evaluate the efficacy of an active rehabilitation protocol for youth who are slow to recover from concussion. It is hypothesised that an active rehabilitation intervention can reduce persistent postconcussion symptoms, improve function and facilitate return to activity. This article describes the research protocol.Methods and analysisThis is a randomised clinical trial with blinded outcome measurement. Participants will be recruited and randomly assigned to 1 of 2 treatment groups, an active rehabilitation intervention or a standard care education group. Both groups will receive standard care education. However, the active rehabilitation group will participate in an additional low-intensity exercise programme consisting of aerobic, coordination and visualisation exercises. Both the active rehabilitation and the standard care education interventions will be 6 weeks in duration. The primary outcome measure is postconcussion symptoms. Secondary outcome measures include functional recovery (cognitive, motor, psychosocial and emotional functioning) and return to activity. Outcome measures will be administered preintervention and postintervention. The primary outcome measure will also be repeated 2 weeks into the intervention period.Ethics and disseminationThis study has been approved by the Holland Bloorview Kids Rehabilitation Hospital research ethics board (REB # 13-459). The findings from this study will be shared with the general public, sport associations, relevant brain injury organisations and healthcare professionals.Trial registration numberNCT02257749.</description><subject>Adolescent</subject><subject>Brain Concussion - complications</subject><subject>Child</subject><subject>Children & youth</subject><subject>Concussion</subject><subject>Consent</subject><subject>Exercise</subject><subject>Exercise - physiology</subject><subject>Exercise Therapy</subject><subject>Female</subject><subject>Heart Rate</subject><subject>Humans</subject><subject>Intervention</subject><subject>Male</subject><subject>Mental health</subject><subject>Participation</subject><subject>Patient Compliance</subject><subject>Patient Education as Topic</subject><subject>Post-Concussion Syndrome - etiology</subject><subject>Post-Concussion Syndrome - rehabilitation</subject><subject>Psychomotor Performance - physiology</subject><subject>Recovery of Function</subject><subject>Rehabilitation</subject><subject>Research Design</subject><subject>Self Care</subject><subject>Single-Blind Method</subject><subject>Sports and Exercise Medicine</subject><subject>Teenagers</subject><issn>2044-6055</issn><issn>2044-6055</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkUtr3DAUhUVJaEKSX1Aogm6ycaK35C4KZcgLErJJtxWyLScebF1Xkgvz76thpiHtKtpcifudgw4HoU-UXFDK1WUzrWH2oWKEyooQI5T5gI4ZEaJSRMqDN_cjdJbSmpQjZC0l-4iOmGKcaqmO0c8HF9yzn3zIGHo8-5iGlLevGVJuIbRLSgMEnDbTnGFKeAh4A0t--Yodji50MA3Jd7igOcKIcxzciOcIGVoYT9Fh78bkz_bzBP24vnpa3Vb3jzd3q-_3VSM0y5VjpPFcasl9KxvhWNOzTnkuGm1q3vNa9FI5Sonriev6hrTUeMeM1kbXglB-gr7tfOelmXzXlgDRjXaOw-TixoIb7L-bMLzYZ_hthWRUcl0MzvcGEX4tPmVbYrV-HF3wsCRLNaGmFkxt0S__oWtYYijxLDWKGEprUheK76g2QkrR96-focRuK7T7Cu22QrursKg-v83xqvlbWAEudkBRv8vxD1BjqhA</recordid><startdate>20150731</startdate><enddate>20150731</enddate><creator>Reed, Nick</creator><creator>Greenspoon, Dayna</creator><creator>Iverson, Grant L</creator><creator>DeMatteo, Carol</creator><creator>Fait, Philippe</creator><creator>Gauvin-Lepage, Jérôme</creator><creator>Hunt, Anne</creator><creator>Gagnon, Isabelle J</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>9YT</scope><scope>ACMMV</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20150731</creationdate><title>Management of persistent postconcussion symptoms in youth: a randomised control trial protocol</title><author>Reed, Nick ; Greenspoon, Dayna ; Iverson, Grant L ; DeMatteo, Carol ; Fait, Philippe ; Gauvin-Lepage, Jérôme ; Hunt, Anne ; Gagnon, Isabelle J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b472t-a20be35753ec5b4a2bf2d6e34b7893f394f56a110af0adfb0c18ea28778794013</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adolescent</topic><topic>Brain Concussion - complications</topic><topic>Child</topic><topic>Children & youth</topic><topic>Concussion</topic><topic>Consent</topic><topic>Exercise</topic><topic>Exercise - physiology</topic><topic>Exercise Therapy</topic><topic>Female</topic><topic>Heart Rate</topic><topic>Humans</topic><topic>Intervention</topic><topic>Male</topic><topic>Mental health</topic><topic>Participation</topic><topic>Patient Compliance</topic><topic>Patient Education as Topic</topic><topic>Post-Concussion Syndrome - etiology</topic><topic>Post-Concussion Syndrome - rehabilitation</topic><topic>Psychomotor Performance - physiology</topic><topic>Recovery of Function</topic><topic>Rehabilitation</topic><topic>Research Design</topic><topic>Self Care</topic><topic>Single-Blind Method</topic><topic>Sports and Exercise Medicine</topic><topic>Teenagers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Reed, Nick</creatorcontrib><creatorcontrib>Greenspoon, Dayna</creatorcontrib><creatorcontrib>Iverson, Grant L</creatorcontrib><creatorcontrib>DeMatteo, Carol</creatorcontrib><creatorcontrib>Fait, Philippe</creatorcontrib><creatorcontrib>Gauvin-Lepage, Jérôme</creatorcontrib><creatorcontrib>Hunt, Anne</creatorcontrib><creatorcontrib>Gagnon, Isabelle J</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database (ProQuest)</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Reed, Nick</au><au>Greenspoon, Dayna</au><au>Iverson, Grant L</au><au>DeMatteo, Carol</au><au>Fait, Philippe</au><au>Gauvin-Lepage, Jérôme</au><au>Hunt, Anne</au><au>Gagnon, Isabelle J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Management of persistent postconcussion symptoms in youth: a randomised control trial protocol</atitle><jtitle>BMJ open</jtitle><addtitle>BMJ Open</addtitle><date>2015-07-31</date><risdate>2015</risdate><volume>5</volume><issue>7</issue><spage>e008468</spage><epage>e008468</epage><pages>e008468-e008468</pages><issn>2044-6055</issn><eissn>2044-6055</eissn><abstract>IntroductionCurrent management of concussion consists of early education, rest until symptom free, with gradual return to school and physical activity protocols. Although this management strategy is effective for most youth who sustain a concussion, it is not an appropriate strategy for youth with persistent postconcussion symptoms. Prolonged rest and periods of restricted activity may place youth at risk for secondary issues and contribute to the chronicity of postconcussion symptoms. The purpose of this study is to evaluate the efficacy of an active rehabilitation protocol for youth who are slow to recover from concussion. It is hypothesised that an active rehabilitation intervention can reduce persistent postconcussion symptoms, improve function and facilitate return to activity. This article describes the research protocol.Methods and analysisThis is a randomised clinical trial with blinded outcome measurement. Participants will be recruited and randomly assigned to 1 of 2 treatment groups, an active rehabilitation intervention or a standard care education group. Both groups will receive standard care education. However, the active rehabilitation group will participate in an additional low-intensity exercise programme consisting of aerobic, coordination and visualisation exercises. Both the active rehabilitation and the standard care education interventions will be 6 weeks in duration. The primary outcome measure is postconcussion symptoms. Secondary outcome measures include functional recovery (cognitive, motor, psychosocial and emotional functioning) and return to activity. Outcome measures will be administered preintervention and postintervention. The primary outcome measure will also be repeated 2 weeks into the intervention period.Ethics and disseminationThis study has been approved by the Holland Bloorview Kids Rehabilitation Hospital research ethics board (REB # 13-459). The findings from this study will be shared with the general public, sport associations, relevant brain injury organisations and healthcare professionals.Trial registration numberNCT02257749.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>26231756</pmid><doi>10.1136/bmjopen-2015-008468</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Brain Concussion - complications Child Children & youth Concussion Consent Exercise Exercise - physiology Exercise Therapy Female Heart Rate Humans Intervention Male Mental health Participation Patient Compliance Patient Education as Topic Post-Concussion Syndrome - etiology Post-Concussion Syndrome - rehabilitation Psychomotor Performance - physiology Recovery of Function Rehabilitation Research Design Self Care Single-Blind Method Sports and Exercise Medicine Teenagers |
| title | Management of persistent postconcussion symptoms in youth: a randomised control trial protocol |
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