A New Way to Gauge Pediatric Concussion

A practical, age-appropriate treadmill protocol outlines how clinicians can safely assess exercise intolerance and guide concussion management in children aged 5 to 12 years.

By
Kathryn Wighton
January 13, 2026
3 min

Conexiant

At a Glance

Category	Detail
Condition	Pediatric Concussion
Key Mechanisms	Assessment of exercise tolerance through graded treadmill testing.
Target Population	Children aged 5 to 12 years.
Care Setting	Clinical settings for concussion management.

Key Highlights

Children reaching 70% of age-predicted maximum heart rate without symptom increase are exercise tolerant.
The Pediatric Concussion Treadmill Test is tailored for children, addressing limitations of adult protocols.
Testing includes acclimation, symptom monitoring, and structured exertion assessment.
The test aligns with American Heart Association guidelines for pediatric cardiac stress testing.
Systematic identification of exercise intolerance informs concussion severity and management.

Guideline-Based Recommendations

Diagnosis

Conduct a comprehensive clinical concussion evaluation.

Management

Utilize subsymptom threshold aerobic exercise as the primary treatment for concussion recovery.

Monitoring & Follow-up

Record baseline resting heart rate and symptom severity before testing.

Risks

Terminate testing with symptom exacerbation, voluntary exhaustion, or safety concerns.

Patient & Prescribing Data

Children aged 5 to 12 years post-concussion.

Exercise tolerance assessment can guide individualized management strategies.

Clinical Best Practices

Incorporate the Pediatric Concussion Treadmill Test into concussion evaluations.
Monitor heart rate and symptoms throughout the testing process.
Ensure acclimation to the treadmill before exertion testing.