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Updated: Jan 22, 2026

A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion
Published on: September 25, 2014
Activity Level During Acute Concussion May Predict Symptom Recovery Within an Active Duty Military Population
Rosemay A Remigio-Baker1, Jason M Bailie, Emma Gregory
1Defense and Veterans Brain Injury Center, Silver Spring, Maryland (Drs Remigio-Baker, Bailie, Gregory, Cole, Stuessi, Ettenhofer, and Mullins and Ms Andrews); Naval Hospital Camp Pendleton, Concussion Care Clinic, Camp Pendleton, California (Drs Remigio-Baker, Bailie, and Stuessi); Venesco LLC, Chantilly, Virginia (Drs Remigio-Baker and McCulloch and Ms Andrews); General Dynamics Health Solutions, Silver Spring, Maryland (Drs Bailie and Stuessi); Naval Medical Center San Diego, San Diego, California (Ms Andrews and Drs Mullins and Ettenhofer); Department of Brain Injury Medicine, Womack Army Medical Center, Fort Bragg, North Carolina (Drs Cole and Cecchini); Department of Allied Health Sciences, The University of North Carolina at Chapel Hill (Dr McCulloch); and American Hospital Services Group, LLC, Exton, Pennsylvania (Dr Ettenhofer).
Objective:
To evaluate the impact on symptom resolution of activity acutely following a concussion and the role of acute-phase symptoms on this relationship among active duty service members (SMs).
Setting:
Three military installations.
Participants:
Sixty-two SMs aged 18 to 44 years who sustained a concussion within 72 hours of enrollment.
Design:
Longitudinal design with data collected within 72 hours of injury (baseline, n = 62) and at 1 week (n = 57), 1 month (n = 50), 3 months (n = 41), and 6 months (n = 40) postinjury.
Main Measures:
Baseline activity level using a 60-item Activity Questionnaire. Symptom level at baseline and during follow-up using Neurobehavioral Symptoms Inventory.
Results:
Significant interaction (Pi < .05) was found, with significant main effects (P < .05) limited to SMs with elevated baseline symptomatology. Among these participants, greater baseline total activity was significantly related to greater vestibular symptoms at 1, 3, and 6 months (β = .61, .63, and .59, respectively). Significant associations were also found for particular types of baseline activity (eg, physical; vestibular/balance; military-specific) and symptoms at 1, 3, and/or 6 months postinjury.
Conclusion:
These results provide support for clinical guidance that symptomatic SMs, particularly those with high levels of acute symptoms, may need to avoid excessive activity acutely following concussion.
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