OBJECTIVE: To evaluate the evidence related to how physical activity (PA) affects recovery following a sport-related concussion (SRC) in adolescents. DESIGN: Systematic review Data Source: PubMed, Medline, and SPORTDiscus Eligibility criteria for selecting study: (1) original research article (eg, randomized controlled trials (RCT), quasi-experimental designs, cohort, case-control studies), (2) 66% or greater of the sample has to have a SRC diagnosed by a clinician, (4) human research, (5) evaluate the effect of a SRC on PA in adolescents only (< 18 years). Participants were seen within 1 to 2 weeks post-SRC for acute studies and 4 weeks post-SRC for studies focused on prolonged recoveries. RESULTS: Twenty-two studies met the inclusion criteria (ie, 8 regarding PA (PA-daily aerobic activity including light-moderate intensities), 8 evaluating active rehabilitation/exercise programs (20 minutes of daily aerobic exercise below symptom threshold), 6 examining a single bout of exertion). The methodological quality of the literature was assessed using the Downs and Black risk of bias (ROB) checklist. The ROB scores ranged from 7 to 24, with only two RCTs included. Studies demonstrated single bouts of exertion testing were safe and feasible. Daily PA or active rehabilitation/exercise programs led to a reduction in symptoms present and a decrease in number of days to medical clearance. CONCLUSION: Following a brief period of rest (24 to 48 hours), individuals can gradually and safely return to PA below their physical symptom exacerbation thresholds. Further research is warranted to delineate how to optimize the timing, intensity, duration, and modality of PA impacts symptom resolution and physiological recovery following SRC.

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