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Description

Prescribe Sub-Symptom Exercise for Adolescent Concussion.

A clinical decision support system for sub-symptom threshold aerobic exercise (SSTAE) prescription in adolescents with persistent post-concussion symptoms (PPCS). Implements an evidence-based protocol derived from a systematic review of seven studies (Li, 2026; <doi:10.17605/osf.io/kvuf6>), encoding safety screening, Buffalo Concussion Treadmill Test (BCTT)-guided heart rate prescription, session-level progress tracking, and evidence disclosure using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework into an open-source tool for athletic trainers and clinicians. Designed to support implementation in resource-limited settings where BCTT equipment may be unavailable. GRADE certainty of evidence: LOW. For clinician use only; not a substitute for clinical judgement.

PPCSexRx

Prescribe Sub-Symptom Exercise for Adolescent Concussion

Clinical decision support R package for sub-symptom threshold aerobic exercise (SSTAE) in adolescents with persistent post-concussion symptoms (PPCS). Implements an evidence-based protocol from Li (2026), winner of the 2026 NATA Foundation Best Summary Evidence Research Award.

GRADE: LOW certainty | Conditional recommendation FOR
For licensed clinicians only. Not a substitute for clinical judgement.

Evidence synthesis:OSF 10.17605/osf.io/kvuf6
Project site:guanglab.org


Features

FunctionPurpose
screen_ppcs()Eligibility and safety screening
prescribe_ppcs()BCTT-guided (80% HRST) or age-predicted prescription
track_progress()Session log, HR progression, stop-if-worsen rules

Installation

install.packages("PPCSexRx")

Requirements: R ≥ 4.0


Quick start

library(PPCSexRx)

screen_ppcs(age = 16, days_post_injury = 35)
rx <- prescribe_ppcs(age = 16, days_post_injury = 35, hrst = 165)
print(rx)

log <- NULL
tr <- track_progress(log, pcss = 30, duration_min = 20, achieved_hr = 120, rx)

See vignette("PPCSexRx") after installation.


Citation

Primary evidence synthesis:

Li G (2026). Sub-symptom Threshold Aerobic Exercise for Adolescents With PPCS: A Critically Appraised Topic. Winner, 2026 NATA Foundation Best Summary Evidence Research Award. https://doi.org/10.17605/osf.io/kvuf6


License

MIT — see LICENSE.

Author

Guang Li[email protected]
PhD Student, Idaho State University · Guang Lab
ORCID 0009-0004-2807-9029

Metadata

Version

0.1.1

License

Unknown

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