Secondary Logo

Institutional members access full text with Ovid®

Share this article on:

The Role of Physical Activity in Recovery From Concussion in Youth: A Neuroscience Perspective

Schmidt, Julia, PhD; Rubino, Cristina, MSc; Boyd, Lara A., PhD; Virji-Babul, Naznin, PhD

Journal of Neurologic Physical Therapy: July 2018 - Volume 42 - Issue 3 - p 155–162
doi: 10.1097/NPT.0000000000000226
Special Interest Articles

Background and Purpose: Concussion is a major public health concern and one of the least understood neurological injuries. Children and youth are disproportionally affected by concussion, and once injured, take longer to recover. Current guidelines recommend a period of physical and cognitive rest with a gradual progressive return to activity. Although there is limited high-quality evidence (eg, randomized controlled trials) on the benefit of physical activity and exercise after concussion, most studies report a positive impact of exercise in facilitating recovery after concussion. In this article we characterize the complex and dynamic changes in the brain following concussion by reviewing recent results from neuroimaging studies and to inform physical activity participation guidelines for the management of a younger population (eg, 14-25 years of age) after concussion.

Summary of Key Points: Novel imaging methods and tools are providing a picture of the changes in the structure and function of the brain following concussion. These emerging results will, in the future, assist in creating objective, evidence-based pathways for clinical decision-making. Until such time, physical therapists should be aware that current neuroimaging evidence supports participation in physical activity after an initial and brief period of rest, and consider how best to incorporate exercise into rehabilitation to enhance recovery following concussion.

Recommendations for Clinical Practice: It is important that physical therapists understand the neurobiological impact of concussion injury and recovery, and be informed of the scientific rationale for the recommendations and guidelines for engagement in physical activity.

Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, available at:

University of British Columbia, Canada (J.S., C.R., L.A.B., N.V-B.); and La Trobe University, Melbourne, Australia (J.S.).

Correspondence: Naznin Virji-Babul, PhD, Faculty of Medicine, Department of Physical Therapy, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada (

J.S. has fellowship funding by the Michael Smith Foundation for Health Research; C.R. is funded by the Natural Sciences and Engineering Research Council of Canada.

The authors declare no conflict of interest.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (

© 2018 Academy of Neurologic Physical Therapy, APTA