This article was initially published in the 10/29/26 edition of our Concussion Update newsletter; please consider subscribing.
Researchers have developed a new, remotely delivered aerobic exercise program for youth with persisting symptoms after concussion, called the Mobile Subthreshold Exercise Program (MSTEP). In a randomized clinical trial led by Sara Chrisman and published in JAMA Pediatrics, the program was shown to improve the speed of concussion recovery as well as health-related quality of life in youth (compared to a stretching routine). Speeding recovery is important for youth because it allows them to return to school and other activities sooner. The data suggest that this type of program is most helpful when delivered within 3 months of injury, during the acute or subacute phase. This study builds on previous research that focused on acute concussion and in-person care, aiming to expand access to care by examining a longer time period and remote program delivery.
This study included 210 participants, who were randomly assigned to either complete the MSTEP program or complete a stretching routine. Participants were 11-18 years old and had sustained a concussion in the past year. The MSTEP program begins with aerobic exercise targeting 60% of maximum heart rate and gradually increases in intensity over six weeks, with clinical oversight via weekly videoconferencing calls. Participants were also given activity trackers.
The researchers collected data on concussion symptoms, health-related quality of life, sleep, depression, and anxiety. They found that concussion symptoms and health-related quality of life improved across all time points, and that the MSTEP group showed significantly higher levels of improvement at 3 months than the control group, indicating that the MSTEP program led to faster recovery than the stretching routine. At 6 months, no significant differences between the groups were observed. Sleep, anxiety, and depression also improved over time, but no significant differences were observed between groups.
