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Observational Study Adds Evidence of Post-Concussion Exercise Benefit

John J. Leddy, MD

John J. Leddy, MD

Published March 10, 2017

An observational study published in the Journal of the American Medical Association is part of a growing body of evidence suggesting that long periods of rest may not help concussion patients recover, according to UB researchers.

“The study tells us that strict rest after a concussion is not the way to go. What it doesn’t tell us is whether exercise is definitely better.”
Clinical professor of orthopaedics

The research shows an association between fewer post-concussion symptoms and early post-concussion physical activity.

Newly Published Study Does Not Prove Causation

UB researchers first reported in 2010 that sub-threshold physical activity was therapeutic in athletes and non-athletes who had a concussion. They note, however, that the new study by Canadian researchers still doesn’t prove causation.

“The study tells us that strict rest after a concussion is not the way to go. What it doesn’t tell us is whether exercise is definitely better,” says John J. Leddy, MD, clinical professor of orthopaedics and medical director of the UB Concussion Management Clinic.

UB Leading Randomized, Controlled Clinical Trial

Because the new study is observational, it doesn’t control for possible confounding factors as would be the case in a randomized, controlled clinical trial, in which participants are randomly assigned to an intervention or a control group, he adds.

That’s the goal of a study Leddy is currently conducting. It is the first randomized, controlled clinical trial of individualized exercise for the treatment of sport-related concussions in adolescents within the first week after injury.

Leddy is conducting it with co-investigator Barry S. Willer, PhD, professor of psychiatry and director of research for the UB Concussion Management Clinic.

“Our study hypothesis is that early, controlled exercise below the threshold where symptoms are exacerbated will speed recovery from concussion,” Leddy says.

“We’ve always maintained that the level of physical activity after a concussion should be individualized and should always stay below the level where it would exacerbate symptoms.”

Also Studying Physiological Mechanisms Involved

Results of the study, to be completed on approximately 100 adolescents who have experienced a concussion while playing a sport, are expected toward the end of 2017.

Funded by the Ralph C. Wilson Foundation and the Program for Understanding Childhood Concussion and Stroke, it is being conducted by physicians at UBMD Orthopaedics & Sports Medicine and through the University of Manitoba in Canada.

The National Institutes of Health also recently funded Leddy and Willer to investigate the physiological mechanisms involved in adolescents who experience a concussion.