Moving for Recovery: Using time-use compositions to Explore Physical Activity and Sleep in Sports-Related Concussion
DOI:
https://doi.org/10.51224/SRXIV.548Keywords:
Physical activity, movement, exercise, concussion, mTBI, TBI, , brain injury, recovery, CoDA, compositional data analysis, time-use epidemiologyAbstract
Sports-related concussions are a prevalent and often misunderstood form of traumatic brain injury worldwide. While earlier clinical guidelines advocated for strict physical and cognitive rest until full symptom resolution, a growing body of evidence now supports the inclusion of physical activity (PA) as a critical component of effective concussion recovery. To date, much of the research has examined the role of PA in isolation, without accounting for the inherently interdependent nature of daily movement behaviours. Time-use composition frameworks address this limitation by analysing how time is proportionally distributed across various activities and how reallocating time among these behaviours can influence health outcomes. To the author’s knowledge, this is the first study to employ Compositional Data Analysis (CoDA) to assess the relative contributions of four key movement behaviours - sedentary behaviour, light PA, moderate-to-vigorous PA, and sleep - on concussion recovery. Using a homogeneous sample of 35 male athletes with acute sports-related concussion and 45 matched healthy controls, the study explored group differences in time-use composition, optimal behavioural distributions for recovery, and the impact of reallocating time among behaviours. While no statistically significant differences or associations were observed across most movement behaviours, sleep emerged as a positive predictor of recovery time in the unadjusted model. Additionally, although not statistically significant, the compositional isotemporal substitution analysis suggested that reallocating 60 minutes per day to either light or moderate-to-vigorous PA could theoretically shorten recovery duration by approximately four days. These findings demonstrate the potential of CoDA to provide nuanced insights into how the relative distribution of daily activities and sleep may influence concussion recovery. Future research with larger and more diverse samples is warranted to enhance clinical applicability and guide evidence-based treatment recommendations.
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