Controlled exercise gets athletes back in the game
By JOHN DELLACONTRADA
When Buffalo Sabres center Tim Connolly took the ice for the start of the NHL playoffs last week after being sidelined for 11 months with post-concussion syndrome, his return in large part was due to a new treatment program developed by UB researchers.
Likewise, Milwaukee Brewers third baseman Corey Koskie's recovery from post-concussion syndrome now seems more promising since he began the UB program developed by researchers Barry Willer, John Leddy and Karl Kozlowski in the UB Concussion Clinic.
For unknown reasons, 5 to 10 percent of people who experience a concussion have symptoms that persist beyond six weeks. These people are diagnosed with post-concussion syndrome. Previously, there has been no treatment for the condition with proven success.
"The new program is in the experimental stages, but I think it's going to change the way (post-concussion syndrome) is handled," Connolly said.
Willer and his co-researchers call their new treatment "controlled exercise." Basically, they prescribe an individualized exercise program for the athletes. This allows them to begin working out in short intervals. The athletes at first train at a level that doesn't cause symptoms. The level gradually increases until symptoms are gone.
"When he went to UB, you could tell (Connolly's) demeanor completely changed," Sabres defenseman Brian Campbell said in an interview with The New York Times. "When he started working out a little bit and getting back on the exercise bike, you could see progress."
The gradual exercise helps to restore the brain's auto-regulation mechanism that controls blood pressure and supply to the brain, Willer explained. When this system is knocked out of whack by a concussion, victims suffer from dizziness, nausea and headaches when they exert themselves in any way.
"There really isn't anything else available to athletes and others who suffer from post-concussion syndrome," Willer said. "The standard protocol is rest and then antidepressants if the symptoms remain. What kind of treatment is that?
"We offer hope to people suffering from these symptoms, and we're very excited about the results so far," Willer added. "We're optimistic that Corey Koskie will be back this season."
Often athletes with post-concussion syndrome fall into depression when the symptoms don't go away. Sometimes the depression leads to suicide, as was the case with former NFL player Andre Waters, who took his life in November. The affective component of post-concussion syndrome can be just as debilitating as the physical component, Willer pointed out. If an athlete thinks his or her brain is permanently damaged, it threatens their image of the future. Feelings of hopelessness arise. It's a very scary scenario, particularly for a young athlete whose hopes were so high.
"One of our first patients was a 14-year-old girl, top athlete, top student, but she couldn't get through a day in school," Willer said. "What do you think that did to her self image? She only told us after we started her in treatment that she had considered suicide. Within two days of starting treatment, her depressive symptoms were absolutely gone."
Willer also works with nonathletes and may begin working with U.S. soldiers returning from Iraq. He and his colleagues have treated a dozen athletes and nonathletes to date. All have had a significant reduction in symptoms and most are symptom free.
The UB treatment program was described in the September issue of Current Treatment Options in Neurology. For more information about the UB Concussion Clinic, go to http://www.ubortho.buffalo.edu/concussion/clinic.html.