Physical activity after mild traumatic brain injuries in young adults: Is it recommended, and can it decrease the symptoms of post-concussion syndrome?

Children Moving Around Room with Caretaker on Couch

Mild traumatic brain injuries (mTBIs) are one of the most common injuries among young adults in the United States. mTBI is commonly associated with post-concussive syndrome (PCS), which includes symptoms such as headaches, dizziness, fatigue, loss of concentration and memory, and insomnia. While these symptoms typically resolve within four weeks, a small percentage of the affected population can experience prolonged physical and mental impairment for up to two years. Recent media attention on the prevalence of mTBI among professional athletes has led to an increase in research funding for brain injuries. Researchers and clinicians alike are using these funds to work towards innovative diagnosis and treatment strategies for mTBI.

The general health benefits of physical activity are well known. Currently, research also suggests that physical activity can have positive effects for adults who are recovering from mTBI. The known after-effects of physical activity – including decreased stress, emotion and mood regulation, improved attention, and enhanced blood pressure regulation – all have the potential to directly combat some of the negative effects of PCS. However, individuals who have sustained mTBI may be unsure if exercise poses a safety risk during the recovery period. This is especially true among young adults, who are less represented in the current research.

A research team in the Netherlands sought to better understand the relationship between physical activity and symptoms of PCS, such as fatigue and insomnia, in young adults who experienced mTBI. They conducted a cross-sectional study assessing the physical activity patterns of 49 mTBI patients aged 12 to 25 years, and they found that more than half did not meet Dutch national physical activity guidelines. These guidelines, which are similar to those in the United States, recommend that children should be moderately to vigorously active for 60 minutes every day. Based on these guidelines, the researchers separated the participants based on their physical activity. They used measures of fatigue and quality of sleep to compare symptoms of PCS in each group, and they found that those who were less physically active were significantly more likely to experience fatigue than the group who met physical activity guidelines. There was no relationship between physical activity and sleep quality.

Similar to earlier findings among older adults, physical activity appears to have a positive effect on mTBI recovery in adolescents and young adults. They suggest that decreased fatigue is related to cardiovascular conditioning and preservation of skeletal muscle, both of which are factors associated with physical activity. Further research is necessary to best understand this relationship and its underlying mechanisms. Additionally, there is a need for studies assessing exercise type, frequency, intensity, and duration in order to optimize the safety and effectiveness of therapeutic exercise interventions for mTBI recovery.


van Markus-Doornbosch et al. Physical activity after mild traumatic brain injury: What are the relationships with fatigue and sleep quality. Eur J Peadiatr Neurol, 23.1 (2019): 53-60.

Barlow et al. Epidemiology of postconcussion syndrome in pediatric mild brain injury. Pediatrics, 126.2 (2010): e374-81.

Thurman D, The epidemiology of traumatic brain injury in children and youths: A review of research since 1990. J of Child Neurol, 3 (2016): 20-27.

Mossberg K. Endurance training and cardiorespiratory conditioning after traumatic brain injury. J Head Trauma Rehabil, 25.3 (2010): 173-83.

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