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Post-Concussion SyndromeREPConNCT05785000

Rehabilitation in Post Concussion Syndrome

A study testing Physical exercise programme as an add-on in people with Post-Concussion Syndrome, run by Copenhagen University Hospital, Rigshospitalet at 1 site in Denmark.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This project evaluates and quantifies the effects of an individually tailored exercise program applied to patients with long-lasting symptoms after concussion, minor traumatic brain injury, so-called Post-Concussion Syndrome (PCS). Read more about this study

Who is it for?
Ages 18 to 70 yearsHealthy volunteers can take part
Conditions the study is for
Post-Concussion Syndrome
What is being tested?
Physical exercise programme as an add-on
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
70 participants
Where
1 siteDenmark
Study dates
1 Feb 2023to Apr 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 70 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Post concussion syndrome (PCS) diagnose according to WHO ICD-10 classification and documented by written statement from physician veritying a mild traumatic brain injury
  • Longer lasting symptoms for at least 4 weeks after initial trauma
  • If allocated to add-on exercise protocol participant must feel able to prioritize the intervention structure
  • Communication language must be Danish

Who cannot join

  • Other diseases blurring the diagnose PCS
  • Other serious brain diseases
  • Severe cardiovascular diseases precluding physical activity according to protocol

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Henrik BW Larsson, Professor contact

(+45) 24824294

henrik.bo.wiberg.larsson@regionh.dk

Mette K Zebis, PhD contact

(+45) 30291943

mzeb@kp.dk

Denmark1 site, 1 recruiting
  • University College Copenhagen

    Copenhagen, Region of Greater Copenhagen, 1799

    Mette K Zebis, Affiliate Professor, +45 51632437, mzeb@kp.dk

    Henrik BW Larsson, Professor, +45 38632432, henrik.bo.wiberg.larsson@regionh.dk

    Recruiting

Other trials in Denmark

About this study

Official title: Rehabilitation of Adult Patients With Post Concussion Syndrome

This project evaluates and quantifies the effects of an individually tailored exercise program applied to patients with long-lasting symptoms after concussion, minor traumatic brain injury, so-called Post-Concussion Syndrome (PCS). The project investigates the phenomenon Post Concussion Syndrome in four dimensions with a focus on both patient perspectives of PCS, an interventional physical program, a neurobiological basis for PCS through Magnetic Resonance Imaging (MRI) and finally through a 360-degree evaluation of the entire project involving patients and scientists in a reflective process.

Read the detailed description

The project has four parts

Aims and hypotheses:

  1. The aim is to describe and nuance the subjective patient perceived aspects of living with PCS including the individual experiences of symptom provocation or relieve after the initial trauma. Part one is concept developing and involves qualitative in-depth interviews of patient experiences of obstacles for living a normal life with special emphasis of intolerance to activity and exercise.
  2. The aim is to assess the effects of adding a 12 week individually tailored pulse-controlled aerobe exercise program to usual care. The hypothesis is that it is possible to increase the physical capacity measured by the number of minutes of pulse-training without symptom provocation. By increasing the number of minutes the threshold value of symptom provocation will be moved upwards for a training group (TG) of patients compared to a control group (CG) who carry on in their usual activities and treatments here defined as usual care.
  3. The aim is to measure quantitative components of the neurobiological aspects of PCS by magnetic resonance imaging (MRI). The hypothesis is that patients with PCS have more leakiness of the blood-brain barrier (BBB) compared to healthy controls. In addition, PCS patients have disturbance of brain metabolism, abnormal microstructural tissue organization and abnormal brain activity. Furthermore, that intervention will normalize these MRI metrics in a training group (TG) compared to a control group (CG).
  4. The aim is to obtain qualitative components of having patients and scientists evaluating the project. The evaluation will comprise participants involved, i.e. both patients in the 2 arms and researchers and the goal of this 360-degree evaluation is to describe perceived experiences of strength, weakness, possibility and threat (SWOT) of the intervention and ultimately prevent development of PSC after a minor traumatic brain injury.

Methods - the four parts:

  1. Qualitative interviews of PCS participants focusing on individual perception of own situation, detailed symptom description, hindrance of living a normal life.
  2. All PSC patients continue daily living and own developed coping strategies. The intervention is an add-on. We use Short Message Service (SMS) tracking every week obtaining details of wellbeing related to living with concussion. The intervention consists of bi-weekly one hour exercise guided by physiotherapist for 12 weeks. Clinical status is performed four times- before and after 12 weeks and with two interim assessments. We use the validated Buffalo Concussion Bike Test (BCBT ). Blood pressure, pulse rate, pulse oxymetri and exercise level are registered and we use Visual Analog Scale (VAS) and BORG Ratings of Perceived Exertion (BORG RPE) scales. In addition we use the Rivermead Post Concussion Questionnaire (RPCQ ).
  3. Blood brain barrier (BBB) permeability is measured by Dynamic Contrast Enhanced Magnetic Resonance Imaging (DCE-MRI) using a conventional MRI contrast agent. Both the leakiness (Ki) of the BBB, brain blood volume, capillary mean transit and distribution of transit times are estimated together with brain tissue perfusion (CBF). Other functional MRI measures are obtained such as the brain microstructural organization, measured by diffusion sensitive MRI and brain activity by Blood-oxygenation level dependent Imaging and brain lactate production as a measure of brain metabolism.
  4. The 360-degree evaluation of the entire project is a joint, narrative process where patients, researcher and students involved sit together using a process evaluating principle. A data triangulation and a reflection of pros and cons of the project will guide the process. The evaluation is guided by an expert in process evaluation.
Being tested
Physical exercise programme as an add-on, Control patients receiving usual care
Keywords
Mild traumatic brain injury, Brain function, Magnetic Resonance Imaging, Buffalo Concussion Bike Test, Patient perception, 360-degree evaluation
Medical subject headings
Post-Concussion Syndrome, Brain Concussion

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Physical exercise programme as an add-onOther

    Consists of an individually tailored bike exercise program guided by symptoms, pulse rate and patient specific judgement of exertion monitored also by BORG RPE and VAS and progressively increasing time and level of resistance below symptom provocation

  • Control patients receiving usual careOther

    No exercise intervention

Study groups in NCT05785000
Study groupRoleWhat they receive
Aerobe graded physical exercise intervention and usual careExperimentalPhysical exercise program. The experimental programme is an add-on to usual care and consists of an aerobe graded exercise program performed twice a week for 12 weeks. Usual care includes all public treatments that each patient is assigned to at entry to REPCon. The provision of officially available treatments follow the Danish Health Care Act.
Receives: Other: Physical exercise programme as an add-on
Usual carePlacebo comparatorNo physical exercise program in a patient control group with PCS. This group continues with usual care, but all clinical test, interviews and MRI protocol are the same.
Receives: Other: Control patients receiving usual care

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Buffalo Concussion Bike Test from baseline measurement to week 12

    Buffalo Concussion Bike Test is an individualized bike test designed to measure the number of minutes that the patient can cycle without symptom aggrevation. The test is stopped when symptoms worsen judged by VAS, BORG RPE and pulse rate. The result is measured in minutes

    Measured: Change in Buffalo Concussion Bike Test at week 12

Secondary outcomes (20)
  1. Changes in Rivermead Post Concussion Questionaire from baseline to week 12

    A systematic questionary related to patient perception of commotio during past 24 hours. Result is in point with a maximum possible score of 3 and 13 points

    Measured: Change in point score at week 12

  2. Changes in Fatique Scale Questionaire from baseline to week 12

    A systematic questionary related to patient perception of fatique. Result is in points with a maximum possible score of 63 points

    Measured: Change in point score at week 12

  3. Change in Buffalo Concussion Bike Test from baseline measurement to week 4

    Buffalo Concussion Bike Test is an individualized bike test designed to measure the number of minutes that the patient can cycle without symptom aggrevation. The test is stopped when symptoms worsen judged by VAS, BORG RPE and pulse rate. The result is measured in minutes

    Measured: Change in Buffalo Concussion Bike Test at week 4

  4. Change in Buffalo Concussion Bike Test from baseline to week 8

    Buffalo Concussion Bike Test is an individualized bike test designed to measure the number of minutes that the patient can cycle without symptom aggrevation. The test is stopped when symptoms worsen judged by VAS, BORG RPE and pulse rate. The result is measured in minutes

    Measured: Change in Buffalo Concussion Bike Test at week 8

  5. Description of patient perspectives of living with PCS

    In a grounded theory frame we develop new descriptions of patient experiences

    Measured: Assessed at week 12

  6. Evaluation of the project

    In a SWOT analyses frame we develop qualitative concepts of the project

    Measured: After completion of the 12 week intervention

  7. Change in Sms tracking domain one: "Physical Ability" of self reported well being in relation to commotio

    All included patients fill out an electronic questionary related to five domains of well being. Result of score is a number from 0 to 10

    Measured: Change in perceived physical ability at week 12

  8. Change in Sms tracking domain two: "Overall physical symptoms" of self reported well being in relation to commotio

    All included patients fill out an electronic questionary related to five domains of well being. Result of score is a number from 0 to 10

    Measured: Change in perceived overall physical symptoms at week 12

  9. Change in Sms tracking domain three: "Using the brain" of self reported well being in relation to commotio

    All included patients fill out an electronic questionary related to five domains of well being. Result of score is a number from 0 to 10

    Measured: Change in perception of "using the brain" at week 12

  10. Change in Sms tracking domain four: "Work ability" of self reported well being in relation to commotio

    All included patients fill out an electronic questionary related to five domains of well being. Result of score is a number from 0 to 10

    Measured: Change in perception of work ability

  11. Change in Sms tracking domain five: "Quality of daily living" of self reported well being in relation to commotio

    All included patients fill out an electronic questionary related to five domains of well being. Result of score is a number from 0 to 10

    Measured: Change in perception of quality of daily life

  12. Changes in Dynamic Gait Index Questionaire from baseline to week 12

    A systematic questionaire related to functional and dynamic balance during gait. Result of score is in points with a maximum of 24 points

    Measured: Change in dynamic gait at week 12

  13. Change in blood brain barrier permeability from baseline to week 12

    Normalization of blood brain barrier permeability in the intervention group. Blood brain barrier permeability measured in mLiter/minute/mLiter of brain tissue (mL/min/mL)

    Measured: Change in blood brain barrier permeability at week 12

  14. Change of brain oxygen consumption from baseline to week 12

    Normalization of oxygen consumption in the intervention group. Measured in unit mmol oxygen/minute/ mLiter of brain tissue (mmol/min/mL).

    Measured: Change of brain oxygen consumption at week 12

  15. Change of brain diffusion from baseline to week 12

    Normalization of brain diffusion in the post concussion intervention patient group. Diffusion coefficient is measured in meter^2/second (m^2/s).

    Measured: Change of brain diffusion at week 12

  16. Change of brain lactate from baseline to week 12

    Normalization of lactate in the intervention group. Measurement of lactate in mmol/ml brain tissue.

    Measured: Change of brain lactate at week 12

  17. Case- control comparison; Blood brain barrier permeability

    Blood brain barrier permeability measurement comparison between healthy controls and patients with post concussion syndrome. Measurement in mLiter/minute/mLiter of brain tissue (mL/min/mL)

    Measured: Comparison measurements at baseline

  18. Case-control comparison; Brain oxygen consumption

    Global brain oxygen consumption normalized to total brain volume comparison between healthy controls and patients with post concussion syndrome. Measured in unit mmol oxygen/minute/ mLiter of brain tissue (mmol/min/mL)

    Measured: Comparison measurements at baseline

  19. Case-control comparison; Brain diffusion coefficient

    Brain water diffusion coefficient comparison between healthy controls and patients with post concussion syndrome. Diffusion coefficient measured in meter^2/second (m^2/s).

    Measured: Comparison measurements at baseline

  20. Case-control comparison; Brain lactate

    Measurement of brain lactate in precuneus comparison between healthy controls and patients with post concussion syndrome. Measurement in mmol/ml brain tissue.

    Measured: Comparison measurements at baseline

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Mar 2023
  2. Study start1 Feb 2023
  3. Primary completion1 Aug 2025
  4. Study completionApr 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Patients are recruited through our professional networks, via clinics, hospital emergency departments, general practitioners, physiotherapeutic clinics, flyers at educational institutions and patient associations. Inclusion age is 18-70 years, both genders. PCS symptoms of at least 4 weeks persistence after initial trauma and patients must be able to document the traumatic brain event from either emergency room or other medical doctor. Exclusion criteria: other diseases interfering with presentation of PCS symptoms. Up to fifty healthy controls are included only in the MRI part. Healthy controls are recruited by advertising in public media. This part of the project is also constituted as a separate case control study comparing PCS patients and healthy controls Seventy patients with PCS are randomized to either intervention as an add on to usual care or to control. Randomization is performed as a block-randomization with permuted block of size 2-6 generated via computer.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
70 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05785000
Sponsor's protocol ID
Repcon123
Acronym
REPCon
Status last verified
Apr 2025
First submitted
6 Mar 2023
Last updated
22 Jan 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Larsson BW, Zebis MK, Vismann J, Orner FF, Tireli ED, Clausen KD, Fenger I, Shacham DA, Tireli D, Haraldsson BT, Cramer SP, Lindberg U, Vestergaard MB, Sylliaas H, Amin FM, Larsson HBW. Rehabilitation Involving Tailored Subsymptomatic Aerobic Exercise in Adult Patients With Persistent Postconcussion Symptoms (REPCon Project): Protocol for an Assessor-Blinded, Parallel-Group, Randomized Controlled Trial. JMIR Res Protoc. 2026 Jun 4;15:e93795. doi: 10.2196/93795.

    PubMed 42241591

Questions about this trial

What is this clinical trial studying?

A study testing Physical exercise programme as an add-on in people with Post-Concussion Syndrome, run by Copenhagen University Hospital, Rigshospitalet at 1 site in Denmark.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 22 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Denmark. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Henrik BW Larsson, Professor ((+45) 24824294, henrik.bo.wiberg.larsson@regionh.dk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Buffalo Concussion Bike Test from baseline measurement to week 12 (time frame: Change in Buffalo Concussion Bike Test at week 12). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05785000, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Jan 2026.

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