Brain Gain

York University professor, athletic therapist and kinesiologist Danielle Dobney (BA ’06) is working to make aerobic exercise a more widely used therapy for young patients who are slow to recover from concussions.

Dobney – who graduated from and is now an assistant professor in York’s Kinesiology and Athletic Therapy programs – has been researching concussion management and working with concussion patients for over a decade. Her interest in this area was piqued as a York University student in 2006, during a time when research into concussions was taking off.

“People were just beginning to recognize that concussions weren’t ‘just a bump on the head,’” she says. “It was being recognized as a brain injury, and there was so much we didn’t know. At that time, rest was really the only strategy in managing a concussion.”

Traditionally, clinicians advised against exercise for children and teens who experienced persistent symptoms following a concussion. But for many patients she worked with, Dobney saw that withholding light exercise was having a negative effect.

“The longer they were inactive, the worse they felt. They experienced emotional symptoms from being so limited in what they could do. When I started letting my patients do a bit of exercise at a low level, it lifted their mood to be able to do something,” she explains.

She focused on aerobic exercise as a concussion management strategy while pursuing her PhD in rehabilitation sciences at McGill University under the supervision of Isabelle Gagnon, who was leading innovative research in this area.

In 2017, Dobney and her research team conducted a study that prescribed an active rehabilitation program to 277 youths experiencing persistent concussion symptoms. They found that the patients demonstrated improved physical, cognitive, emotional and sleep-related post-concussion symptoms following the treatment.

Despite its potential benefits, aerobic exercise is currently an underused therapy for concussion management.

In a study published in 2021 that surveyed 555 clinicians about what treatment they would recommend for two clinical vignettes, Dobney and Gagnon found that just over one-third prescribed aerobic exercise.

“Clinicians were prescribing a wide variety of treatments, many of which didn’t have supporting evidence. However, treatment for which there is supporting evidence (such as aerobic exercise) was prescribed less frequently,” Dobney explains.

The next step in the research will focus on knowledge translation and raising awareness of aerobic exercise as an effective concussion management strategy among clinicians.

“It took a long time to have this research move into clinical practice because having people with concussion symptoms take part in exercise was contrary to what had been previously recommended,” Dobney says. “It takes a long time to move research into practice, especially when it contradicts previous knowledge or evidence.”  ■