4.4 Aerobic exercise for sport-related concussion: a systematic review and meta-analysis
Bibliographic record
Abstract
Objective To assess the effects of symptom-limited aerobic exercise programs compared to control interventions, on symptom intensity, time to recovery, balance, cognitive capacity and adverse events in individuals with sport-related concussion (SRC). Design Systematic review with meta-analyses. Participants After scrutinized four databases (MEDLINE, EMBASE, CINHAL and EBM Reviews) with specific inclusion criteria (RCTs, SRC population [any ages], aerobic exercise as one of the interventions studied), seven RCTs (326 participants) in adolescents (no studies retrieved in adults or elderly) were included. Intervention Symptom-limited aerobic exercise programs compared to a control intervention. Outcome Measures Symptom intensity (post-concussion symptoms scale or inventory), time to recovery, balance, cognitive capacity and adverse events. Main Results Three out of seven RCTs had a high risk of bias according to the Cochrane risk of bias tool. Symptom-limited aerobic exercise interventions have a significant beneficial effect on perception of symptoms (6 studies, 277 participants, low quality evidence according to GRADE recommendations, pooled SMD 95%CI: -0.44 [-0.68, -0.19]). When introduced in the acute phase, a symptom-limited aerobic exercise intervention has a significant beneficial effect on symptoms improvement compared to a control intervention (3 studies, 206 participants, moderate quality evidence according to GRADE recommendations, pooled SMD 95%CI: -0.43 [-0.71, -0.15]). For other outcomes, quantitative analysis was not possible. Adverse events were mild, and no between-group difference were reported. Conclusion A symptom-limited aerobic exercise program is beneficial in improving the symptoms of adolescents who have sustained a SRC. Good quality studies are needed to determine effects on adults and other variables. This abstract has been published in full manuscript format and has the following citation: BMJ Citation https://pubmed.ncbi.nlm.nih.gov/32520867/
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.016 | 0.029 |
| Meta-epidemiology (narrow) | 0.004 | 0.002 |
| Meta-epidemiology (broad) | 0.020 | 0.050 |
| Bibliometrics | 0.008 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".