Navigation Links
UB specialized exercise regimen shown to relieve prolonged concussion symptoms
Date:1/19/2010

BUFFALO, N.Y. -- University at Buffalo researchers are the first to show that a controlled individualized exercise training program can bring athletes and others suffering with post-concussion syndrome (PCS) back to the playing field or to their daily activities.

In a paper published in the January issue of the Clinical Journal of Sport Medicine, the researchers report that a program of progressive exercise developed individually for each participant and performed at levels just below the onset of symptoms is safe and can relieve nearly all PCS symptoms.

Their results counter the accepted wisdom that PCS should be treated with rest, reassurance and antidepressants, and that physical activity should be avoided.

"Perhaps the most exciting aspect of this study is that all of the subjects that participated, both athletes and non-athletes, got better eventually, although the athletes certainly improved the fastest," says Barry Willer, PhD, UB professor of psychiatry and rehabilitation sciences and senior author on the study.

"It also was reassuring to discover that the use of exercise was safe and did not prolong symptoms, a worry expressed by other practitioners."

John J. Leddy, MD, associate professor of orthopaedics and co-director of UB's Sports Medicine Institute, where the study was conducted, is first author on the study. Willer, Leddy and Karl Kozlowski, PhD, UB clinical instructor of exercise and nutrition sciences, developed the exercise protocol. (To view a slide show about a patient who participated in the UB program, go to http://www.youtube.com/watch?v=pUEmfnIIhwM.)

For unknown reasons, 5-10 percent of people who experience a concussion have symptoms that persist beyond six weeks. These persons are diagnosed with PCS. Previously there was no treatment for the condition with proven success.

The UB regimen is based on the hypothesis that the regulatory system responsible for maintaining cerebral blood flow, which may be dysfunctional in people with a concussion, can be restored to normal by controlled, graded, symptom-free exercise.

The researchers developed their program in 2004. "We were testing athletes for return to sport using an exercise test," says Willer, "and we decided that if an athlete becomes symptomatic at a heart rate of, say, 140, maybe they could exercise at a heart rate of 125, without complications. We soon discovered that the athletes got better much quicker if they exercised."

Physicians in UB's Sports Medicine Concussion Clinic initially used their approach only with athletes from UB teams, but word spread, and they now have assessed and treated many professional athletes, especially those from the National Hockey League.

"One of the advantages we offer to professional teams is a more precise test of post-concussion syndrome," says Leddy. "If the patient does not develop symptoms during the exercise test, then the cause of their difficulties is likely to be another source. Most commonly it is neck strain, which tends to cause headaches that mimic post-concussion headache."

For the preliminary study just published, the researchers enrolled six non-athletes who suffered concussions in auto accidents or falls, along with six athletes, five who were injured in their sport and one in a car accident.

Participants were tested initially on a treadmill to determine the exercise intensity that triggered symptoms. With individual baselines established, each participant exercised at 80 percent of that intensity every day for three weeks and then returned for a repeat test. In most instances, retesting demonstrated that participants could work at a higher intensity and the exercise protocol then was increased. This pattern continued until participants could exercise completely without experiencing PCS symptoms.

As might be expected, the athletes recovered more quickly than the non-athletes, results showed. They returned to normal within 11 to 36 days, while the non-athletes required 41 to 112 days of intervention. All participants had returned to work, school or athletic activities at a three month post-program follow-up.

Ten of the 12 participants were completely free of symptoms at follow-up. One participant still experienced cognitive and visual symptoms, and another, who had a history of migraines, continued to experience headaches.

"The data suggest that some PCS symptoms are related to disturbed cerebral autoregulation, and that after this treatment, the brain was able to regulate blood flow when the blood pressure rose during exercise," says Leddy. "We think progressive stepwise aerobic training may improve cerebral autoregulation by conditioning the brain to gradually adapt to repetitive mild elevations of systolic blood pressure."

Kozlowski adds that although each concussion should be considered a "unique injury," a randomized trial that included a PCS control group should be conducted to address the possibility that PCS symptoms would have resolved spontaneously without intervention.

"All of our subjects had been symptomatic for months before treatment and were not getting better on their own," says Kozlowski, "so we are pretty convinced that the regulated exercise program did the trick." A grant application to NIH to conduct such a randomized trial currently is under review.


'/>"/>

Contact: Lois Baker
ljbaker@buffalo.edu
716-645-4606
University at Buffalo
Source:Eurekalert

Related biology news :

1. Asthma and other allergies tied to absence of specialized cells
2. Mice use specialized neurons to detect carbon dioxide in the air
3. Negative emotions outweigh intent to exercise at health clubs
4. Young adults who exercise get higher IQ
5. 5 exercises can reduce neck, shoulder pain of women office workers
6. Improved diet and exercise alone unlikely to cure obstructive sleep apnea in obese patients
7. UF study: Exercise improves body image for fit and unfit alike
8. 1-finger exercise reveals unexpected limits to dexterity
9. New study finds lowfat chocolate milk is effective post-exercise recovery aid for soccer players
10. Differences among exercisers and nonexercisers during pregnancy
11. Effects of maternal exercise on fetal breathing movements
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:3/31/2016)... March 31, 2016   ... or the "Company") LegacyXChange is excited to ... its soon to be launched online site for trading ... ) will also provide potential shareholders a sense ... technology to an industry that is notorious for fraud. ...
(Date:3/29/2016)... BOCA RATON, Florida , March 29, 2016 /PRNewswire/ ... ("LegacyXChange" or the "Company") LegacyXChange "LEGX" and SelectaDNA/CSI Protect ... Synthetic DNA in ink used in a variety of ... preventing theft. Buyers of originally created collectibles from athletes ... authenticity through forensic analysis of the DNA. ...
(Date:3/22/2016)... India , March 22, 2016 /PRNewswire/ ... market research report "Electronic Sensors Market for Consumer ... Proximity, & Others), Application (Communication & IT, ... Geography - Global Forecast to 2022", published ... industry is expected to reach USD 26.76 ...
Breaking Biology News(10 mins):
(Date:6/23/2016)... ... June 23, 2016 , ... Supplyframe, the Industry ... Supplyframe Design Lab . Located in Pasadena, Calif., the Design Lab’s mission ... hardware projects are designed, built and brought to market. , The Design Lab ...
(Date:6/23/2016)... 2016  Blueprint Bio, a company dedicated to identifying, ... community, has closed its Series A funding round, according ... "We have received a commitment from Forentis Fund ... to meet our current goals," stated Matthew Nunez ... to complete validation on the current projects in our ...
(Date:6/23/2016)... ... June 23, 2016 , ... Regulatory Compliance Associates® ... provides a free webinar on Performing Quality Investigations: Getting to Root ... CT at no charge. , Incomplete investigations are still a major concern to ...
(Date:6/22/2016)... 22, 2016 Cell Applications, Inc. and ... to produce up to one billion human induced ... one week. These high-quality, consistent stem cells enable ... and spend more time doing meaningful, relevant research. ... high-volume manufacturing process that produces affordable, reliable HiPSC ...
Breaking Biology Technology: