24. Real-World Implementation of Early Aerobic Exercise Prescription Accelerates Concussion Recovery in Collegiate Athletes

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ID: 324498
2026
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Ranked #64 of 79 articles by views in archives of clinical neuropsychology : the official journal of the national academy of neuropsychologists

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Abstract
Abstract Purpose To evaluate the association between early aerobic exercise prescription and concussion recovery timelines (i.e., days from injury to symptom resolution and return-to-sport) in collegiate athletes. We hypothesized that incorporating aerobic exercise prescription into concussion management would be associated with faster recovery outcomes. Method We conducted a retrospective medical chart review of diagnosed concussion cases from one NCAA Division-I institution that occurred between August 2019 to December 2025. In August 2022, a Buffalo Concussion Treadmill Test (BCTT)-guided exercise prescription protocol was integrated into the institution’s concussion management policies and procedures. Management was overseen by the institution’s sports medicine team who documented dates of injury, patient-reported symptom resolution, and the completion of the Return-to-Sport strategy. Data from 179 concussions were included in analyses, with 102 exercise prescription cases [20.2±1.6 years old; 63% (n=64) female] and 77 no exercise prescription cases [20.1±1.6 years old; 52% (n=40) female]. Results Median days to symptom resolution and return-to-sport were 5 (IQR:3-9) and 10 (IQR:7-14) in the exercise prescription cases versus 6.5 (IQR:3-10) and 12 (IQR:7.5-18) in the no exercise prescription cases. Cox proportional hazards models adjusting for age, sex, and acute symptom scores showed a significantly greater likelihood of earlier symptom resolution (HR=1.62, 95% CI:1.15-2.31, z=2.73, p=0.007) and return-to-sport (HR=1.74, 95% CI:1.22-2.51, z=3.01, p=0.003) in the exercise prescription cases. Conclusions Aerobic exercise prescription was feasibly implemented by a sports medicine team and led to faster concussion recovery in our collegiate athlete sample. These real-world findings support shifting clinical practice from rest-based care to early, supervised exercise to optimize recovery.
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Authors E Beidler, A Etelamaki, O Mule, A Duda, M C Kitsmiller, M Grisafi, C Crivelli, J Johns, S Labate, J Turnbull, E Teel
Journal archives of clinical neuropsychology : the official journal of the national academy of neuropsychologists
Year 2026
DOI
10.1093/arclin/acag055.024
URL
https://doi.org/10.1093/arclin/acag055.024
Keywords Keywords not found

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