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To explore the relationship between symptoms and exercise tolerance in adolescents following concussion. A retrospective analysis of 417 adolescents who attended a concussion service between January 2015 and April 2021 was performed, with 149 meeting eligibility criteria for inclusion. Post-Concussion Symptom Scale (PCSS) and graded exercise tolerance time (min) were assessed at initial and follow-up visits. Spearman’s correlation was used to examine the relationship between PCSS scores and exercise time. Adolescents (n = 149, 13.9 ± 1.7 years, 66.4% male) presented at 28.6 ± 19.7 days post-injury. Statistically significant correlations were identified between initial (r = −0.36, p &lt; .001) and follow-up (r = −0.41, p &lt; .001) PCSS scores and exercise time among all participants. Initial PCSS and initial exercise time were inversely correlated for males (r = −0.24, p = .018) and females (r = −0.22, p = .127). Follow-up PCSS and follow-up exercise time were inversely correlated for males (r = −0.30, p = .003) and females (r = −0.35, p = .014). There is a statistically significant relationship between higher PCSS and poorer exercise time and both factors should be considered together to provide the most accurate assessment, particularly in females.

Greater symptom burden results in reduced exercise tolerance in adolescents following concussion