Poster Presentation

Early Resistance Exercise in Post-Concussion Rehabilitation

A Preliminary Observational Study of Weightlifting During Acute Concussion Recovery in NCAA Division I Athletes

AMSSM 36th Annual Meeting · Seattle, WA · April 24–29, 2026

Study Overview

Current concussion protocols emphasize aerobic sub-symptom exercise, but resistance training is typically restricted until later stages of recovery. Sub-symptom exercise has been shown to increase Brain-Derived Neurotrophic Factor (BDNF) and Insulin-like Growth Factor-1 (IGF-1), both of which support neuroplasticity. This observational study evaluated whether supervised resistance activity — introduced earlier in recovery — leads to symptom exacerbation or prolonged recovery in NCAA Division I athletes.

Ethics & design: A preliminary, single-arm observational study approved by the UCLA Institutional Review Board [IRB #pending]; all participants provided informed consent. As an uncontrolled pilot, findings are hypothesis-generating — see limitations.

Design

Prospective Observational

Enrollment

11 NCAA D1 Athletes

Demographics

8 Female · 19.8 ± 1.4 yrs

Intervention Timing

5.2 ± 2.0 Days Post-Injury

Key Findings

Preliminary results from 11 NCAA Division I athletes presented at AMSSM 2026.

0 / 11

Athletes With Worse SCAT6 After Weightlifting

No adverse events reported during the study

Symptom Burden

22.9 → 0.9

SCAT6 Score: Initial → Day After WL

96% reduction · p = 0.002 · d = −1.26

Symptom Response

55% / 45%

Improved / Unchanged Day After WL

Wilcoxon p = 0.03

Exertion

11.1 vs 15.1

RPE: Weightlifting vs. Buffalo Test

p = 0.002

Recovery Timing

ρ = 0.75

Earlier WL → Faster Symptom Resolution

Spearman p = 0.005

Return to Play

10.3 days

Mean Return-to-Sport Time (±3.4)

Within expected SRC timelines

Symptom Resolution

6.5 days

Mean Time to Symptom Resolution (±2.4)

Within expected SRC timelines

Takeaway

Preliminary findings indicate that supervised resistance activity introduced early in post-concussion rehabilitation was not associated with prolonged recovery or symptom exacerbation in NCAA Division I athletes. Weightlifting was perceived as less exertional than the standardized Buffalo Concussion Treadmill Test, and earlier weightlifting correlated with faster symptom resolution. These findings support further investigation into early resistance exercise as a potential adjunct to current concussion recovery protocols.

How to Interpret These Results

This is a preliminary, single-arm observational study of 11 athletes with no control group. The large effect sizes (e.g., Cohen’s d = −1.26) are striking but should be read as hypothesis-generating, not definitive. Symptom improvement over time is expected during normal concussion recovery, so without a comparison group these results cannot establish that resistance exercise caused faster recovery.

No control group: improvements cannot be attributed to the intervention versus natural recovery, regression to the mean, or placebo effects.
Selection bias: athletes who felt well enough to lift may have been recovering faster already — the correlation between earlier lifting and faster resolution may reflect, rather than cause, milder injury.
Small sample (n = 11): limits generalizability and inflates effect-size estimates; a few individuals strongly influence the results.
Protocol variability & confounders: resistance training differed across athletes, and uncontrolled factors (sleep, prior history, concurrent therapy) were not adjusted for.

These findings motivate a future controlled trial; they should not yet change clinical return-to-play practice.

Download the AMSSM 2026 Poster

PDF · 1.4 MB · Presented April 2026, Seattle, WA

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Measurements

Symptom & Exertion Tracking

Sport Concussion Assessment Tool 6 (SCAT6)

Standardized symptom score at initial evaluation, day of weightlifting, and day after

Visual Analog Scale (VAS)

Symptom severity rating before and after each training session

Rate of Perceived Exertion (RPE)

Borg 6–20 scale for weightlifting sessions and Buffalo Concussion Treadmill Test

Investigators & Authors

Kyle Lau, MD

First Author

UCLA · Division of Sports Medicine

Jeremy Swisher, MD

Co-Author

UCLA · David Geffen School of Medicine

Jeffery Ezennia, MD

Co-Author

UCLA · Division of Sports Medicine

Jeremy Vail, PT, SCS, OCS

Co-Author

UCLA Athletics

Joshua Goldman, MD, MBA

Senior Author

UCLA · David Geffen School of Medicine

Want to get involved?

UCLA varsity athletes can join an active study, and researchers or partners can collaborate with the HERO Lab.

Enroll as an Athlete Collaborate

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