Implementing a structured exercise program for persistent concussion symptoms: a pilot study on the effects on salivary brain-derived neurotrophic factor, cognition, static balance, and symptom scores

Brain Inj. 2018;32(12):1556-1565. doi: 10.1080/02699052.2018.1498128. Epub 2018 Jul 23.


Primary objective: Persistent concussion symptoms (PCS) affect 10-30% of individuals after sports-related concussion. This study evaluated the effect of exercise-based rehabilitation on symptom scores, brain-derived neurotrophic factor (BDNF), cognitive functions and static balance in a sample of participants with PCS.

Research design: One group pre-test post-test pilot study.

Methods and procedure: Nine participants with PCS received a structured exercise-based rehabilitation program. Changes in symptom scores, BDNF, cognitive functions and measures of static balance were used to evaluate the utility of the exercise program.

Main outcome and results: The results of this pilot study indicate a significant improvement in symptom scores following treatment, as well as some associated benefits in regards to cognitive function and static balance. BDNF levels in the participants with PCS within this study are notably lower than in a previous study on healthy controls.

Conclusions: The preliminary evidence reported in the current pilot study is clinically relevant as our findings suggest exercise-based treatments may improve PCS outcomes in a more favourable manner than rest-based treatment.

Keywords: Persistent concussion symptoms; active rehabilitation; brain-derived neurotrophic factor; neuroplasticity; sports-related concussion.

MeSH terms

  • Adolescent
  • Adult
  • Biomarkers / metabolism
  • Brain-Derived Neurotrophic Factor / metabolism*
  • Cognition / physiology*
  • Exercise Therapy* / methods
  • Female
  • Humans
  • Male
  • Neuropsychological Tests
  • Physical Therapy Modalities
  • Pilot Projects
  • Post-Concussion Syndrome / physiopathology
  • Post-Concussion Syndrome / rehabilitation*
  • Program Evaluation
  • Saliva / metabolism*
  • Young Adult


  • Biomarkers
  • Brain-Derived Neurotrophic Factor
  • BDNF protein, human