The exercise and concussion health study (TECHS): Pilot and feasibility protocol

Mild traumatic brain injury (mTBI) is a prevalent neurological condition, affecting millions worldwide, and frequently resulting in persistent cognitive impairment that significantly impacts daily functioning. Current clinical management and recommendations lack evidence based therapeutic interventions, with treatment approaches limited to symptom monitoring and activity modification. Non-pharmaceutical interventions are needed to promote cognitive recovery and mitigate long-term consequences of mTBI. The goal of this randomized control pilot study is to evaluate the feasibility and preliminary efficacy of a symptom-guided and virtually delivered aerobic exercise intervention for improving cognitive function following mTBI. We are conducting a 12-week pilot randomized control trial of exercise to promote recovery from mTBI, which aims to recruit 24 participants who have suffered an mTBI within the last year and are between the ages of 18-55 years old. Participants are randomly assigned to one of two groups: an intervention group receiving 90 min of virtually-delivered, symptom-guided aerobic exercise weekly for 12 weeks, or a control group receiving 90 min of virtually-delivered balance exercises weekly for 12 weeks. Comprehensive assessments, including cognitive testing and multimodal neuroimaging, were conducted pre and post intervention. We implement physical activity monitoring during weeks 1, 6, and 12 using accelerometry to measure behavior changes. This study will establish the feasibility of virtual exercise delivery in mTBI populations and preliminary evidence regarding cognitive and brain health benefits of aerobic exercise in mTBI. Results will inform future large-scale trials and contribute to an accessible, evidence-based intervention for cognitive recovery after mTBI.