The role of exercise-based testing for effective recovery from concussion in children and adolescents

Abstract

Children and adolescents are more vulnerable to concussion due to developmental reasons and typically take longer to recover compared to adult counterparts. Persistent post-concussion symptoms can affect multiple facets of life including social interaction, education, participation in sport or recreational activity, sleep, and mood. Exercise, shown to improve recovery outcomes in youth with concussion, is often guided by conventional methods of exercise testing, but can be challenging to implement. The overall aim of this thesis is to explore the role of exercise testing in children and adolescents with concussion, including younger, often under-represented, children who may be less suited toward standard methods of graded exercise testing. Graded exercise testing was safely administered in youth, including children as young as four years, and provided an effective measure of functional status and symptom monitoring, as well as informed clinical decision-making. The findings from this thesis advance the role of exercise-based testing in paediatric patients with concussion and promote graded exercise testing as standard-care practice.