Navigation Links
UB specialized exercise regimen shown to relieve prolonged concussion symptoms

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

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
University at Buffalo

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:
(Date:11/4/2015)... ALBANY, New York , November 4, 2015 /PRNewswire/ ... According to a new market report published by Transparency ... Size, Share, Growth, Trends and Forecast 2015 - 2022", ... value of US$ 30.3 bn by 2022. The market ... during the forecast period from 2015 to 2022. Rising ...
(Date:10/29/2015)... ANN ARBOR, Mich. , Oct. 29, 2015 ... with Eurofins Genomics for U.S. distribution of its ... DNA-seq kit and Rubicon,s new ThruPLEX Plasma-seq ... DNA to enable the preparation of NGS libraries ... in plasma for diagnostic and prognostic applications in ...
(Date:10/27/2015)... Munich, Germany , ... (ASGM) automatically maps data from mobile eye tracking videos ... so that they can be quantitatively analyzed with SMI,s ... Germany , October 28-29, 2015. SMI,s Automated Semantic ... eye tracking videos created with SMI,s Eye Tracking ...
Breaking Biology News(10 mins):
(Date:11/24/2015)... 24, 2015 Halozyme Therapeutics, Inc. (NASDAQ: HALO ) ... New York on Wednesday, December 2 at 9:30 ... president and CEO, will provide a corporate overview. th ... at 1:00 p.m. ET/10:00 a.m. PT . Jim ... provide a corporate overview. --> th Annual Oppenheimer ...
(Date:11/24/2015)... Worcester, Mass. (PRWEB) , ... November 24, 2015 ... ... need to maintain healthy metabolism. But unless it is bound to proteins, copper ... Institutes of Health (NIH), researchers at Worcester Polytechnic Institute (WPI) will conduct a ...
(Date:11/24/2015)... , Nov. 24, 2015 /PRNewswire/ - Aeterna Zentaris Inc. ... IIROC on behalf of the Toronto Stock Exchange, confirms ... there are no corporate developments that would cause the ... --> --> About Aeterna Zentaris ... . --> Aeterna Zentaris is a specialty ...
(Date:11/24/2015)... , November 24, 2015 ... new market research report "Oligonucleotide Synthesis Market by Product ... (PCR, Gene Synthesis, Diagnostic, DNA, RNAi), End-User (Research, Pharmaceutical ... published by MarketsandMarkets, the market is expected to reach ... in 2015, at a CAGR of 10.1% during the ...
Breaking Biology Technology: