Aerobic Exercise for Adolescents With Prolonged Symptoms After Mild Traumatic Brain Injury: An Exploratory Randomized Clinical Trial.

The study was exploratory and small, so it cannot prove that cycling is the right treatment for all adolescents with lingering concussion symptoms. The stretching group also received an active program and regular visits, so the comparison does not show cycling is better than no treatment. Participants knew which group they were in, and symptom improvement was partly based on self-report. Parent ratings did not show the same difference as adolescent self-ratings, so the finding depends on which report is used. People with significant neck symptoms or primarily vestibular symptoms were excluded, so the result does not apply to those patients. Many eligible adolescents did not enroll, and the study did not compare them with participants, so the sample may be biased. Adherence was recorded by participant logs, which can be inaccurate. The study enrolled adolescents from a single local area and was undersized for subgroup findings. Both groups improved from baseline, so the trial does not isolate aerobic training from natural recovery.

The paper reports extramural NIH research support, and the authors declared no conflicts of interest.

Do not conclude that aerobic cycling is proven treatment for all adolescents with lingering concussion symptoms. This was an exploratory randomized trial with a small sample, and the benefit appeared in self-reports but not parent or caregiver reports.