Efficiency of an Active Rehabilitation Intervention in a Slow-to-Recover Paediatric Population following Mild Traumatic Brain Injury: A Pilot Study

Abstract

Objective . The aim of this study was to identify whether the addition of an individualised Active Rehabilitation Intervention to standard care influences recovery of young patients who are slow-to-recover following a mTBI. Methods . Fifteen participants aged<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mn fontstyle="italic">15</mml:mn><mml:mo>±</mml:mo><mml:mn fontstyle="italic">2</mml:mn></mml:math>years received standard care and an individualised Active Rehabilitation Intervention which included (1) low- to high-intensity aerobic training; (2) sport-specific coordination exercises; and (3) therapeutic balance exercises. The following criteria were used to measure the resolution of signs and symptoms of mTBI: (1) absence of postconcussion symptoms for more than 7 consecutive days; (2) cognitive function corresponding to normative data; and (3) absence of deficits in coordination and balance. Results . The Active Rehabilitation Intervention lasted<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mn fontstyle="italic">49</mml:mn><mml:mo>±</mml:mo><mml:mn fontstyle="italic">17</mml:mn></mml:math>days. The duration of the intervention was correlated with self-reported participation (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:mover accent="true"><mml:mrow><mml:mi>x</mml:mi></mml:mrow><mml:mo>-</mml:mo></mml:mover><mml:mo>=</mml:mo><mml:mn fontstyle="italic">84.64</mml:mn><mml:mo>±</mml:mo><mml:mn fontstyle="italic">19.63</mml:mn></mml:math>%,<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M4"><mml:mi>r</mml:mi><mml:mo>=</mml:mo><mml:mo>-</mml:mo><mml:mn fontstyle="italic">0.792</mml:mn></mml:math>,<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M5"><mml:mi>p</mml:mi><mml:mo>&lt;</mml:mo><mml:mn fontstyle="italic">0.001</mml:mn></mml:math>). The average postconcussion symptom inventory (PCSI) score went from a total of<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M6"><mml:mn fontstyle="italic">36.85</mml:mn><mml:mo>±</mml:mo><mml:mn fontstyle="italic">23.21</mml:mn></mml:math>points to<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M7"><mml:mn fontstyle="italic">4.31</mml:mn><mml:mo>±</mml:mo><mml:mn fontstyle="italic">5.04</mml:mn></mml:math>points after the intervention (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M8"><mml:mi>Z</mml:mi><mml:mo>=</mml:mo><mml:mo>-</mml:mo><mml:mn fontstyle="italic">3.18</mml:mn></mml:math>,<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M9"><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn fontstyle="italic">0.001</mml:mn></mml:math>). Conclusion . A progressive submaximal Active Rehabilitation Intervention may represent an important asset in the recovery of young patients who are slow-to-recover following a mTBI.