Early Resistance Exercise in Post-Concussion Rehabilitation

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

AMSSM 35th Annual Meeting · Seattle, WA · April 23–29, 2026

Study Overview

Evidence on structured resistance exercise during early concussion rehabilitation remains limited. The Amsterdam consensus already permits symptom-limited light resistance exercise during an early rehabilitation step. This observational study tracked symptom responses and recovery timelines after supervised resistance activity in NCAA Division I athletes.

Ethics & design: A preliminary, single-arm observational study approved by the UCLA Institutional Review Board; 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
Lifting Timing and Symptom Resolution Were Correlated
Spearman p = 0.005
Return to Play
10.3 days
Mean Return-to-Sport Time (±3.4)
Descriptive result in this sample
Symptom Resolution
6.5 days
Mean Time to Symptom Resolution (±2.4)
Descriptive result in this sample

Takeaway

No symptom-score worsening after lifting or adverse events were reported among these 11 athletes. The uncontrolled design cannot establish safety, accelerated recovery, or whether lifting changed recovery duration. The reported 96% symptom-score reduction spans the initial assessment to the day after lifting; natural recovery may explain that change. The findings support further controlled research.

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 produces imprecise estimates that can be strongly affected by individual athletes.
  • 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

Download Poster

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?

Ask the research team about current concussion studies and eligibility. Researchers and partners can also contact HERO Lab about collaboration.

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