Objective To determine whether routine daily activity (RDA), non-prescribed exercise (Non-ERx), or prescribed exercise (ERx) following sport concussion was associated with differences in time until symptom-free (SF) and return-to-sport (RTS) in collegiate athletes.

Design Retrospective chart review.

Setting Institutions (n=6) with National Collegiate Athletic Association sponsored sports in the United States.

Participants Electronic medical records from athletes diagnosed with concussions (n=208, 74 females, age=19.70±1.29 years, height=170.88±10.56 cm, mass=68.26±10.88 kg; 134 males, age=20.38±1.36 years, height=185.19±7.50 cm, mass=84.91±7.20 kg) over a 5-year period were examined.

Interventions (or Assessment of Risk Factors) Exercise group (RDA only, Non-ERx, and ERx) served as the independent variable.

Outcome Measures A Kruskal-Wallis test was performed to compare time (in days) from date-of-injury until SF and RTS by exercise group. Post-hoc analyses were performed using Dunn’s procedure.

Main Results The majority (71.6% [149/208]) of participants completed RDA only post-concussion, followed by ERx (17.3% [36/208]) and Non-ERx (11.1% [23/208]). Exercise group was significantly associated with days to SF (H(2)=7.58, p=0.023, η2H=0.02), but not RTS (p=0.88). Post-hoc tests revealed those in the Non-ERx group (median=9 days [range=2–21 days]) took significantly longer to report being SF compared to the ERx group (median =5 days [range=0–18 days]; p<0.01) and the RDA only group (median=6 days [range=0–18 days]; p=0.03).

Conclusions While days to RTS were similar across groups, those in the ERx and RDA groups reported being SF sooner than those in the Non-ERx group. The results warrant further exploration of specific parameters for exercise prescription in collegiate athletes following concussion.