Pilot study of the Sub-Symptom Threshold Exercise Program (SSTEP) for persistent concussion symptoms in youth

Area of Science:

• Pediatric sports medicine
• Neurology
• Rehabilitation science

Background:

• Previous research indicates potential benefits of monitored aerobic exercise for youth with persistent concussion symptoms.
• However, existing studies are limited by small sample sizes.

Purpose of the Study:

• To evaluate the safety and potential benefits of the Sub-symptom Threshold Exercise Program (SSTEP) for adolescents with concussions lasting over one month.
• To explore the effectiveness of a structured exercise intervention in managing prolonged post-concussive symptoms.

Main Methods:

• A retrospective cohort study involving 83 adolescents who underwent the SSTEP intervention.
• Symptom trajectories were analyzed using the symptom subscale of the Sport Concussion Assessment Tool, version 2 (SCAT-2).

Main Results:

• The study included 83 participants, averaging 14.9 years old, with 54% females. Most concussions resulted from sports (76%), primarily football and girls' soccer.
• Comorbidities like ADHD (14%) and depression/anxiety (16%) were present. Most patients showed symptom improvement post-intervention, with no reported worsening.
• Symptoms decreased exponentially after initiating SSTEP, and the improvement trajectory was consistent across different durations of symptoms at presentation.

Conclusions:

• Monitored exercise programs, such as SSTEP, demonstrate safety and potential efficacy in treating persistent concussion symptoms in young individuals.
• Further large-scale, controlled studies are necessary to confirm efficacy and determine optimal timing and duration for these interventions.