BUFFALO, N.Y. -- Sports medicine specialists in the University
at Buffalo's Sports Medicine Institute have developed a new method
for treating athletes who sustain post-concussion syndrome that,
unlike the conventional approach, allows athletes to maintain
conditioning while recovering gradually from the injury.
For unknown reasons, 5-10 percent of people who experience a
concussion have symptoms that persist beyond six weeks. These
people are diagnosed with post-concussion syndrome (PCS).
Previously there has been no treatment for the condition with
"The most common approach by physicians is to recommend no
exercise and prescribe antidepressants," said Barry Willer, Ph.D.,
UB professor of psychiatry and rehabilitation sciences. Willer is
lead author on the paper describing the new method, published in
the September issue of Current Treatment Options in
"Most people with PCS have symptoms of depression," said Willer,
"so anti-depressant treatment makes sense. However, antidepressants
do little more than relieve some of the depression symptoms. We
were interested in a treatment that didn't just treat the symptoms,
but actually improved the patient's brain function."
The researchers call their new treatment "regulated exercise."
The approach consists of determining the ideal exercise program for
each athlete based on a number of individual physiological
indicators at baseline.
Patients are tested every two to three weeks with specialized
equipment at the sports medicine clinic to determine their
progress, and a new program is developed based on those
Willer and co-author John Leddy, M.D., clinical associate
professor of orthopaedics and rehabilitation sciences, indicated it
is too early to call the treatment a cure, but they are optimistic
about the results so far.
The researchers described the treatment method in mid-September
at the 2006 Brain Injury Conference of the Americas in Miami, where
the response was very favorable, according to Willer.
"Professionals at the meeting were delighted that our approach
to treatment of post-concussion syndrome doesn't involve any
medications and is very cost-efficient. We were surprised to learn
that we are among only a few investigators interested in people
with symptoms that won't go away.
"There is no other known treatment specifically for PCS, which
we define as persistent symptoms of concussion past the time they
should have cleared, usually around three weeks," said Willer. "As
far as we can determine, there is only one other group in North
America that is using regulated exercise as part of the treatment
Willer and Leddy have used regulated exercise successfully with
people who were as much as six months post-concussion. Their
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 treatment program is well tolerated by patients" Willer
said. "Just being able to exercise often reduces the depressive
symptoms. But it's imperative that the patient not go beyond the
"After the first three weeks of regulated exercise, we reassess
the patient to see if there has been any change in physiology. The
exercise program then is realigned successively to respond to the
changes. In our experience thus far, symptoms disappear within
several months for at least some of the patients," he said.
The specialists have worked with a small number of patients to
date. They have included a UB soccer player who has returned to
play and now is one of the team's leading scorers. Another young
athlete was able to return to cross-country running and attend
Willer, Leddy and other UB faculty members will present a
half-day seminar on their treatment for concussion and
post-concussion syndrome and the science behind it on Oct. 28 from
7:30 a.m. to noon in Butler Auditorium in Farber Hall on UB's South
(Main Street) Campus.
The seminar, aimed primarily at physicians, also will be open
to the public. Interested persons should contact the UB Office of
Continuing Medical Education at 829-2378 or firstname.lastname@example.org for more