Physiological outcomes of physical activity interventions in persistent postconcussive symptoms: a scoping review protocol.

There are limited therapeutic options for patients with persistent postconcussive symptoms (PPCSs). Most PPCS assessments focus on subjective measures of progression and symptom monitoring. While early exercise interventions for rehabilitation are now considered best practice for acute concussion, no comprehensive review exists on how physical activity objectively and physiologically affects outcomes in PPCS. This scoping review protocol outlines the methods to identify the efficacy of therapeutic exercise interventions for PPCS, emphasising their impact on physiological parameters, including cardiovascular autonomic responses and cerebral autoregulation. Using the Patient, Intervention, Comparison and Outcome (PICO) framework, we will include all studies presenting original data. Narrative summaries will provide clinicians. An initial search in Medline/EMBASE/PubMed, Cochrane Library, PsycINFO, Web of Science and Scopus will be completed. Key parameters from each study will be extracted, tabulated and discussed in a narrative inquiry. The study references will be reviewed for additional studies meeting the inclusion criteria. Future research applications from the findings will be emphasised. After completion of the review, the results will be stratified by type of physical activity as the intervention, emphasising the physiological outcomes. Mapping these findings will allow us to identify the key research priorities for future studies. Findings will be shared with PPCS practitioners and local/national committees and submitted for conferences and publications.