For children and adolescents, guidelines for return to play following concussion recommend a gradual increase in activity, with monitoring for post-concussive symptoms. The authors examined the effect of exercise on PCS and cognition in children and adolescents following the resolution of symptoms post-concussion.

This study included 41 males and 39 females, ranging in age from eight to 18 years, each of whom had been diagnosed with a concussion at an emergency room visit, (CON group). Healthy controls, (HC group), were also recruited, comprising non-injured adolescents, matched for age and cognitive function.

At day two following symptom resolution, the subjects completed an exercise protocol (the McMaster All-Out Progressive Continuous Cycling Test) and post-exercise tests of post-concussive symptoms, using the Cog Sport Symptom Scale (CogSport SS) and a computer-based assessment of cognitive efficacy (the CogSport)．

Results of the CogSport SS demonstrated that the HC group reported an average increase of three symptoms from pre-to post-exercise, while the CON group reported an average decrease by nearly 1.5 symptoms. For the CogSport SS composite, the CON group demonstrated faster reaction times than did the HC group, with this effect more pronounced on the more demanding tasks.

This study of children and adolescents, ranging in age from eight to 18 years, found that exercise did not result in a cognitive decline or greater symptom emergence, as compared with healthy controls.