Nesoddtangen

Persistent Post-concussive Symptoms (PCS) affect about 20% to 30% of people after a mild traumatic brain injury (mTBI). This research evaluates whether a progressive aerobic exercise program, done below the symptom threshold, can reduce symptom burden, improve exercise tolerance, and enhance quality of life in adults with PCS. The study also aims to better understand how mTBI affects the autonomic nervous system (ANS) and its role in persistent symptoms. Participants with exercise intolerance identified by the Buffalo Concussion Treadmill Test (BCTT) will be randomly assigned to either an intervention group or a control group. Both groups will receive standard rehabilitation, but the intervention group will also follow a personalized sub-symptom threshold aerobic exercise program for 12 weeks. This involves exercising about 30 minutes, 3 to 5 times per week, with intensity set at 80-90% of their maximum threshold heart rate. Exercise intensity is monitored using heart rate monitors and the BORG scale, with progress assessed every three weeks and initial weekly guided sessions. Throughout the study, symptom burden will be measured using the Rivermead Post-concussion Symptom Questionnaire (RPQ) at baseline and after 12 weeks. Autonomic nervous system function will be assessed using arterial spin labeling MRI and the Cold Pressor Test at both time points. Participants will track their exercise sessions in diaries, with weekly follow-up reminders from a physiotherapist. The study will also collect other patient-reported outcomes related to autonomic symptoms and exercise tolerance to assess the effects of the intervention comprehensively.