Grant: Doctoral Award - Frederick Banting and Charles Best Canada Graduate Scholarships

The number of concussions occurring each year has increased steadily since 1998 and it has been speculated that concussions may result in the development of secondary conditions, including neurodegenerative diseases. Unfortunately, there is a paucity of research examining incidence rates of concussions in Canada and there is a lack of well-designed research exploring the association between concussions and secondary conditions. Post-concussion syndrome (PCS) is a long-term effect of concussion that involves long-lasting symptoms that limit one's ability at work, school and/or during activity, and occurs in up to 20% of all concussions. However, current PCS diagnosis protocols rely on subjective symptom reports, creating the need for objective markers of PCS. Recent evidence suggests that the way the adult body responds to exercise may serve as an objective indicator of PCS, however data only exists only for adults. Therefore, it is important that these mechanisms be examined in adolescents. Standard rehabilitative care for those who have suffered a concussion involves complete rest until all symptoms resolve, followed by a six-step return-to-play protocol. These protocols are not supported by empirical evidence and are based solely of expert opinion. Furthermore, prolonged periods of rest for those with PCS may lead to physical deconditioning and symptoms of depression. Recent research shows that progressive exercise (PE) may be used safely and effectively to rehabilitate PCS, however findings are limited to adult participants. Therefore, the effects of PE rehabilitation remain to be elucidated in adolescents experiencing PCS. The aims of this proposal are therefore to: 1) identify the incidence rate of concussions and the association between concussions and secondary conditions; 2) examine the effect of PCS on the physiological response to exercise in adolescents; and 3) investigate the physiological response to PE rehabilitation in adolescents with PCS.