Randomized controlled trial of early aerobic exercise following sport-related concussion: Progressive percentage of age-predicted maximal heart rate versus usual care

Figures

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  Fig 1. CONSORT flow diagram of participant enrolment. From 203 eligible participants, 39 participants were randomized into either the structured aerobic exercise prescription (SAEP) or usual care exercise prescription (UCEP) groups. Four participants (SAEP = 3, UCEP = 1) were lost to follow-up and thus censored in the statistical analysis. In addition, two participants discontinued the SAEP intervention: one participant at the first exercise session who was removed from the statistical analysis, and one at the third exercise session that was censored in the statistical analysis. Hence, while there were six participants who were either lost to follow-up (n = 4) or discontinued the intervention (n = 2), only one participant was completely removed from the statistical analysis. Therefore, for the statistical analysis of the primary objectives, both groups had 19 participants.

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  Fig 2. Time to asymptomatic status differs between structured aerobic exercise prescription (SAEP) and usual care exercise prescription (UCEP). (A) Histograms display the posterior distribution of credible values representing the days to symptom resolution in the UCEP (purple) and SAEP (green) groups, as well as the difference in days to symptom resolution (orange). (B) Posterior samples of the survival curve representing the complementary cumulative probability distribution of the proportion of participants in both groups not yet recovered throughout the trial period (Days 1 through 28). The lines represent the estimated mean for each group, and shaded areas represent the estimated 50%, 70% and 90% Compatibility intervals; the dots represent the raw values.

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  Fig 3. Symptom severity differs between structured aerobic exercise prescription (SAEP) and usual care exercise prescription (UCEP). Dots represent individual symptom severity scores for each subject in the UCEP (purple) and SAEP (green) groups, while the shading represents the mirrored density of the group symptom severity scores. Each panel represents symptom severity scores at one of five time points: Enrolment, then at Assessments 1–4. The black lines represent the group medians.