Postconcussion Exercise Volume Associations With Depression, Anxiety, and Dizziness Symptoms, and Postural Stability: Preliminary Findings

Abstract

Objective: To examine the association between postconcussion exercise volume and changes in depression, anxiety, dizziness, and postural stability.

Design: Secondary analysis of a single-site prospective clinical trial.

Setting: Cerebrovascular research laboratory.

Participants: Participants completed questionnaires and underwent tests of gait and balance within 2 weeks of a concussion (mean = 11 ± 3 days postconcussion) and approximately 1 month later (mean = 41 ± 7 days postconcussion). Exercise volume was tracked by weekly exercise logs.

Interventions: On the basis of a previous work classifying exercise volume following concussion, we grouped participants according to self-reported exercise volume between visits as high exercise volume (≥150 min/wk) or low exercise volume (<150 min/wk).

Main outcome measures: Participants completed assessments evaluating anxiety and depression (Hospital Anxiety and Depression Scale), dizziness (Dizziness Handicap Inventory), and postural stability (tandem gait and modified Balance Error Scoring System).

Results: Thirty-eight participants completed the study, of which 22 were in the high exercise volume group (mean = 71 ± 40 min/wk; 16.8 ± 2.1 years; 59% female) and 16 were in the low exercise volume group (mean = 379 ± 187 min/wk; 17.5 ± 2.1 years; 31% female). Although depression symptoms were not significantly different initially (mean difference = 1.5; 95% CI, -0.68 to 3.68; P = .24), the high exercise volume group had significantly lower depression symptom scores at follow-up (mean difference = 3.0; 95% CI, 1.40 to 4.47; P < .001). Anxiety symptoms (mean difference = 2.8; 95% CI, 0.3 to 5.4; P = 0.03), dizziness symptoms (mean difference = 10.9; 95% CI, 0.2 to 21.5; P = .047), single-task tandem gait (mean difference = 3.1 seconds; 95% CI, 0.2 to 6.0; P = .04), and dual-task tandem gait (mean difference = 4.2 seconds; 95% CI, 0.2 to 8.2; P = .04) were significantly better among the high exercise volume group.

Conclusion: Greater exercise volumes were associated with lower depression, anxiety, and dizziness symptoms, and faster tandem gait performance. These preliminary findings suggest a potentially beneficial role for exercise within several different domains commonly affected by concussion.

Trial registration: ClinicalTrials.gov NCT03170856.

Conflict of interest statement

The authors declare no conflicts of interest.

Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

Figures

Figure 1.

Patient-reported outcomes for both groups at the initial and follow-up (four weeks later) time points. Violin plots describe the distribution of measurements in each group, and data are presented as median (center dot, with corresponding number included) and interquartile range (box around the median). The shaded area represents the probability density of data at each level of the scale, smoothed using a kernel density estimator. Follow-up pairwise analyses were conducted for significant interaction effects.

Figure 2.

Postural stability outcomes for both groups at the initial and follow-up (four weeks later) time points. Violin plots describe the distribution of measurements in each group, and data are presented as median (center dot, with corresponding value included) and interquartile range (box around the median). The shaded area represents the probability density of data at each level of the scale, smoothed using a kernel density estimator.