Objective To describe the feasibility and safety of a randomised controlled trial (RCT) comparing active rehabilitation (AR) to treatment as usual (TAU) in adolescents with persistent symptoms following a sport-related concussion.

Design Partially blinded, pilot RCT.

Setting Outpatient Rehabilitation Hospital.

Participants 13 adolescents enrolled and completed the study (10 girls, 3 boys). All were between the ages of 12–18 and were symptomatic for greater than 4 weeks. Participants were excluded if they had more than 1 concussion in the last year, any active mental health disorder, or if their concussion occurred more than 1 year from enrolment.

Intervention Participants were randomly allocated to TAU (occupational therapy and school recommendations) or AR. AR included aerobic exercise, positive visualisation techniques, and sport-specific exercises. AR sessions were supervised by a physiotherapist, and a blinded assessor monitored all participants weekly.

Outcome measures Investigators monitored symptoms using the Post-Concussion Symptom Inventory. Secondary outcome measures included activity level, balance, mood, fatigue, and return to school.

Main results 125 individuals were screened over a 1.25 year period. Of the 22% of individuals deemed eligible, 15 declined to participate. Most commonly, individuals were excluded due to being unreachable, uninterested, or having more than one concussion. No drop outs occurred. An external committee reviewed two adverse events in TAU and 1 adverse event in the AR group. All adverse events were unrelated to the intervention and study procedures.

Conclusions Based on this small pilot study, exercise appeared safe in this sample of youth with persistent symptoms.

Competing interests None.