My daughter rode an exercise bike. I also had her wear a heart rate monitor. Initially, I think she road for like 5-10 minutes keeping her heart rate around 120. She then slowly built up to 30+ minutes - still keeping her heart rate in the same range. We then worked on increasing her heart rate - nothing crazy - up in the 130 range. We'd back down anytime she had an increase in symptoms. After the NUCCA chiropractic adjustments, she had few instances of increased symptoms.

My daughter is about 10.5 months post concussion. The shift for her really started to happen around 6 months. The morning fatigue - i.e. getting up in the AM is the thing that has lingered the longest for her. This wasn't a new issues for her but the severity of it was worsened by the concussion. We still battle with it now.

Most of the head injury related books I have read haven't been really helpful with this issue - other than saying rest and don't over do it. I started reading about Fibramiagia and CFS and there could be some cross over into the PCS. The vitamins & etc that Mark talks about are discussed in great detail. They also talk about other supplements that are helpful. The one that has sparked my interest is SAM-e - it works as anti-depressant and is good for arthritis. After reading about it, I decided to try it myself. I have noticed a big difference in my engery levels during the day. I don't have the same sense of low level fatigue. (Being the parent of a kid with a head injury is definitely stressful and exhausting!) I haven't tried my daughter on it as her doctor doesn't recommend it as there aren't studies done with it's effectiveness with kids. If still continues to struggle, I may revisit it with her doctor.