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BACKGROUND: Prior studies suggest potential benefit using monitored aerobic exercise to treat youth with persistent concussion symptoms, but these studies have been small.

OBJECTIVES: To explore the safety and potential benefits of a rehabilitative exercise intervention, the Sub-symptom Threshold Exercise Program (SSTEP), for treating youth with persistent concussion symptoms> 1 month. METHODS: We conducted a retrospective cohort study of 83 youth who participated in SSTEP, completing trajectory analysis of concussion symptoms using the symptom subscale of the Sport Concussion Assessment Tool, version 2 (SCAT-2). RESULTS: The average age of patients was 14.9+/–2.3 years and 54% were female. Most concussions (76%) were due to sports, the majority from football and girls’ soccer, and 55% had a previous concussion. Comorbidity was not uncommon: 14% had history of ADHD and 16 …