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Updated: Mar 24, 2026
10:31
A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion
Published on: September 25, 2014
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The Role of Controlled Exercise in Concussion Management
John Leddy1, Andrea Hinds2, Dan Sirica3
1UBMD Orthopaedics and Sports Medicine, SUNY Buffalo, 160 Farber Hall, Buffalo, NY 14214(∗).
PM & R : the Journal of Injury, Function, and Rehabilitation
|March 15, 2016
Summary
Prolonged rest after concussion may hinder recovery. Early, individualized exercise, like the Buffalo Concussion Treadmill Test, can improve tolerance and aid recovery for those with postconcussion syndrome.
Area of Science:
- Neurology
- Sports Medicine
- Rehabilitation Science
Background:
- Concussion impacts autonomic nervous system control of cerebral blood flow.
- Traditional concussion management involves prolonged physical and cognitive rest.
- Emerging evidence suggests prolonged rest may impede recovery, leading to deconditioning and depression.
Purpose of the Study:
- To evaluate exercise tolerance in individuals with prolonged postconcussion syndrome (PCS).
- To introduce the Buffalo Concussion Treadmill Test (BCTT) as a tool for assessing exercise intolerance.
- To establish a basis for individualized, subthreshold exercise treatment programs.
Main Methods:
- Development and application of the Buffalo Concussion Treadmill Test (BCTT).
- Systematic evaluation of exercise tolerance using a symptom-exacerbation threshold.
- Individualized subthreshold exercise prescription based on BCTT data.
Main Results:
- The BCTT reliably identifies exercise intolerance in patients with PCS.
- Subthreshold exercise treatment programs improve activity tolerance.
- Restoration of normal exercise tolerance serves as an indicator of physiological recovery.
Conclusions:
- Absolute rest beyond the initial days post-concussion may be detrimental.
- Subthreshold exercise is an appropriate treatment for improving activity tolerance in PCS patients.
- Further research is needed to define optimal exercise parameters in the acute concussion phase.
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