Br J Sports Med 43:508-513 doi:10.1136/bjsm.2008.051748
  • Original article

Sex differences in self-reported symptoms after aerobic exercise in non-injured athletes: implications for concussion management programmes

  1. M B Gaetz1,
  2. G L Iverson2
  1. 1
    Department of Kinesiology and Physical Education, University of the Fraser Valley, British Columbia, Canada
  2. 2
    Department of Psychiatry, Faculty of Medicine, University of British Columbia, British Columbia, Canada
  1. Dr M B Gaetz, Department of Kinesiology and Physical Education, University of the Fraser Valley, 33844 King Road, Abbotsford, British Columbia, Canada V2S 7M8; michael.gaetz{at}
  • Accepted 20 December 2008
  • Published Online First 12 January 2009


Background: After a concussion, when symptoms have decreased substantially at rest, it is recommended that athletes begin light aerobic exercise before progressing to sport specific exercise. The British Columbia Concussion Rehabilitation Programme (BC-CRP) uses a standardized cognitive and exercise test protocol designed to indicate when an athlete should progress to sport-specific exercise after a concussion.

Objective: To document the effects of exercise on symptom reporting in healthy, uninjured, male and female amateur athletes.

Design: Quasi-experimental, pretest–post-test, nonequivalent groups design.

Methods: Before the exercise protocol, 45 female and 30 male young amateur athletes completed computerized cognitive testing, symptom ratings and balance testing. The 15-minute cycle ergometry protocol, conducted at 90 revolutions/minute, was as follows: 0–2 minutes at 0 W tension, 2–5 minutes at 50 W, 5–8 minutes at 100 W, 8–11 minutes at 150 W and 11–14 minutes at 200 W tension followed by a 1-minute cooling-down period. After exercise, participants completed symptom ratings, balance testing and perceived exertion ratings. Self-reported symptoms were assessed using an abbreviated version of the Post-Concussion Scale.

Results: Significant increases in self-reported balance problems, numbness and tingling were seen for both genders after aerobic exercise. For women, emotional symptoms such as irritability, sadness, nervousness and feeling more emotional decreased significantly after aerobic exercise. Headache also decreased in the women, but no significant change was seen in the men.

Conclusions: Sex differences exist for symptom reporting after aerobic exercise. Both genders report increases in somatic symptoms, but only women report decreases in emotional symptoms. The concept of being “asymptomatic” after exercise should be reconsidered to include expected mild increases and decreases in certain symptoms.


  • Competing interests: Both authors are the developers of the British Columbia Concussion Rehabilitation Programme (BC-CRP). GLI has received research funding from the publisher of ImPACT, used as part of the BC-CRP. The research funding is not related to this study or the BC-CRP. Both authors often give presentations at universities, hospitals and conferences relating to MTBI, for which they sometimes receive honoraria.

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