Study of an Exercise Program (STEP) for Youth With Concussion

Inclusion Criteria: * Sports-related concussion that occurred 1-6 months inclusive prior to the start of the study, and was diagnosed by a clinician trained in concussion management consistent with the Zurich definition of concussion ("a complex pathophysiological process affecting the brain, induced by biomechanical forces \[that\] results in a graded set of clinical symptoms that may or may not involve loss of consciousness") * Persistent symptoms as defined by the presence of at least 2 concussive symptoms (from the Health Behavior Inventory, or HBI) at the time of recruitment which were not present prior to injury * 11 to 18 years of age (inclusive) at time of recruitment Exclusion Criteria: * Non-English speaking youth or parents * Unwilling or unable to travel to Seattle Children's Hospital or Seattle Children's Research Institute twice during the course of the study * Cervical spine or vestibular issues requiring further targeted intervention * Other injuries or medical conditions in addition to concussion which would preclude vigorous exercise * Psychiatric hospitalization in the year prior to enrollment * Significant cognitive deficits such as mental retardation or autism * Lack of worsening of concussive symptoms with exertion * Significant abnormalities on routine brain imaging.