A new American research has pointed out that a specialised exercise routine may be the best way for athletes to find relief from post-concussion syndrome (PCS).
According to the study conducted by University of Buffalo researchers, a progressive exercise regimen developed individually for each participant, carried out at levels just below the onset of symptoms, is safe and can mitigate nearly all PCS symptoms.
The findings of the study contradict the much-believed idea that PCS patients should be given rest, reassurance and antidepressants and physical activity should be avoided.
Barry Willer, senior author of the study and UB professor of psychiatry and rehabilitation sciences, said: "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.
"It also was reassuring to discover that the use of exercise was safe and did not prolong symptoms, a worry expressed by other practitioners."
For reasons not yet known, 5-10 percent of people who experience a concussion have symptoms that last beyond six weeks. These persons are diagnosed with PCS.
The UB regimen is based on the premise 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 and symptom-free exercise.
The team designed their program in 2004.
Willer said: "We were testing athletes for return to sport using an exercise test...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."
To start with physicians in UB's Sports Medicine Concussion Clinic used their approach only with athletes from UB teams, but now they have treated many professional athletes.
John J. Leddy, associate professor of orthopaedics and co-director of UB's Sports Medicine Institute, said: "One of the advantages we offer to professional teams is a more precise test of post-concussion syndrome.
"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."
He continued: "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.
"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."
Karl Kozlowski, UB clinical instructor of exercise and nutrition sciences, added: "All of our subjects had been symptomatic for months before treatment and were not getting better on their own...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.
The findings of the study have appeared in the January issue of the Clinical Journal of Sport Medicine.