PROJECT SUMMARY. CANDIDATE: Mathew Wingerson is a doctoral student at the University of Colorado Anschutz School of Medicine pursuing research innovations to support clinical management of concussion. His doctoral research has investigated novel approaches to prescribing aerobic exercise in clinical settings to facilitate concussion recovery. The training plan and research proposed in this F31 application will further equip him for an independent research career investigating post-concussion diagnosis, prognosis, and rehabilitation. DOCTORAL TRAINING PLAN: The training plan aims to (1) develop expertise as a clinical trialist in rehabilitation sciences, (2) expand knowledge in advanced data science methods for clinical research, and (3) gain meaningful experience in concussion fluid biomarkers of recovery and brain pathophysiology. These objectives will be achieved through coursework, research experience, conference attendance, and mentorship from a multidisciplinary team. SPONSOR, CO-SPONSOR, & COLLABORATORS: Dr. David Howell, an expert in concussion research, and Dr. Brianne Bettcher, a specialist in brain biomarkers, will serve as the project sponsor and co-sponsor. Additional contributions from Dr. Jonathan Smirl, a cerebrovascular physiologist, and Dr. Patrick Carry, an applied biostatistician and epidemiologist, will supplement the training plan, providing their expertise to facilitate Mathew’s doctoral education and successful execution of the research project. Dr. Julie Wilson, a physician-researcher and director of concussion clinical care at the Children's Hospital Colorado Sports Medicine Center, offers an expert clinical perspective throughout the execution of the training plan and research, having provided clinical management to children and adolescents with concussion for >13 years. RESEARCH: Active rehabilitation after concussion, including engagement with aerobic exercise, is standard-of-care clinical practice. Existing guidelines for prescribing aerobic exercise are complex, resource- and time-inefficient, and impractical for some clinical settings. Concussion-induced physiological impairments, such as cerebrovascular dysfunction, persist beyond symptom resolution and may not be effectively treated by current rehabilitation guidelines. This proposed research challenges existing clinical practice recommendations by investigating moderate-to-vigorous physical activity (MVPA), an innovative, clinically pragmatic rehabilitation strategy, as an efficacious approach to treating post-concussion physiological disturbances. Leveraging resources and data from an NIH-funded parent study (R01HD108133; enrollment goal: n=288), the project will identify important longitudinal relationships between post-concussion MVPA and cerebrovascular recovery. The study will deliver precise MVPA-based rehabilitative recommendations poised for immediate clinical implementation to facilitate recovery of concussion- induced impairments in physiological system...