Sub-symptom threshold aerobic exercise improves executive function during the early stage of sport-related concussion recovery

We examined whether persons with a sport-related concussion (SRC) derive a postexercise executive function (EF) benefit, and whether a putative benefit is related to an exercise-mediated increase in cerebral blood flow (CBF). Participants with an SRC completed the Buffalo Concussion Bike Test to determine the heart rate threshold (HRt) associated with symptom exacerbation and/or voluntary exhaustion. On a separate day, SRC participants - and healthy controls (HC group) - completed 20-min of aerobic exercise at 80% HRt while middle cerebral artery velocity (MCAv) was measured to estimate CBF. The antisaccade task (i.e. saccade mirror-symmetrical to target) was completed pre- and postexercise to evaluate EF. SRC and HC groups showed a comparable exercise-mediated increase in CBF (ps < .001), and both groups elicited a postexercise EF benefit (ps < .001); however, the benefit was unrelated to the magnitude of the MCAv change. Moreover, SRC symptomology was not increased when assessed immediately postexercise and showed a 24 h follow-up benefit. Accordingly, persons with an SRC demonstrated an EF benefit following a single bout of sub-symptom threshold aerobic exercise. Moreover, the exercise intervention did not result in symptom exacerbation and thus demonstrates that a tailored aerobic exercise program may support cognitive and symptom recovery following an SRC.