Sports Medicine

, Volume 49, Issue 5, pp 683–706 | Cite as

A Physiologically Based Approach to Prescribing Exercise Following a Sport-Related Concussion

  • Phillip R. Worts
  • Scott O. Burkhart
  • Jeong-Su KimEmail author
Review Article


Clinical management of concussion has evolved over the last 20 years, and complete cognitive and physical rest remains a common clinical recommendation. The duration of rest may vary widely, from 24–48 h to several weeks or until the patient’s symptoms have resolved or returned to near baseline levels. Following a period of rest, a stepwise progression of exercise is used for gradual return to play or to work. Previous research in healthy people suggested that prolonged periods of physical inactivity consistently induced deleterious physiological and psychological effects. A growing body of evidence indicates that initiating exercise earlier in the recovery process following a concussion may reduce symptom burden and lower the incidence of post-concussion syndrome. Preliminary findings appear promising, but data on the appropriate exercise prescription for patients who recently sustained a concussion are limited. We reviewed the literature in healthy individuals and patients with concussion and post-concussion syndrome to develop a physiologically based exercise prescription for the days following a concussion. Using this, practitioners may shorten the rest period and initiate controlled exercise earlier during the recovery process following a concussion.


Compliance with Ethical Standards


No sources of funding were used in the preparation of this article.

Conflict of interest

Phillip Worts, Scott Burkhart, and Jeong-Su Kim have no conflicts of interest relevant to the content of this review.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Phillip R. Worts
    • 1
    • 2
    • 3
  • Scott O. Burkhart
    • 4
    • 5
  • Jeong-Su Kim
    • 2
    • 3
    • 6
    Email author
  1. 1.Tallahassee Orthopedic ClinicTallahasseeUSA
  2. 2.Department of Nutrition, Food, and Exercise SciencesThe Florida State UniversityTallahasseeUSA
  3. 3.Florida State University Institute of Sports Sciences and MedicineTallahasseeUSA
  4. 4.Department of Orthopedics and Sports MedicineChildren’s Health Andrews InstituteDallasUSA
  5. 5.Department of PsychiatryUniversity of Texas SouthwesternDallasUSA
  6. 6.The Center for Advancing Exercise and Nutrition Research on AgingTallahasseeUSA

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