Some concussions need more than restPete Kissel
Concussion Treadmill Test and Concussion rehabilitation
If you have suffered a concussion you have probably been to a doctor who has told you to rest. Rest your mind and rest your body until your symptoms go away. And for most people, up to 90% of those who suffer concussions, this advice is sound because symptoms resolve in 7-10 days. If you are more than 7-10 days post injury and still being told only to rest, then this post is for you.
What are post concussive symptoms?
Most commonly people will report headache and dizziness, but there are many other known post concussive symptoms including nausea or vomiting, vision or balance problems and cognitive issues such as difficulty concentrating or remembering. For a full list of post concussive symptoms check out the SCAT 3 symptom evaluation checklist
Buffalo Concussion Treadmill Test
Prolonged rest has negative effects on individuals suffering from persistent concussion symptoms. And while many people will understand the need to slowly start to get moving again, there are many questions…
When should I start?
What kind of exercise should I do?
For how long and at what intensity? Etc.
For several years we have been utilizing the Buffalo Concussion Treadmill Test (short video of BCTT below) to both assess and treat post concussive symptoms that continue to linger beyond the first couple weeks post injury. The treadmill test uses real time heart rate monitoring to give feedback of your physiological response to increasing exertion. Commonly there is an exertion threshold that dramatically increases heart rate and symptoms (sudden increase in light headedness, head ache, pressure or “fullness” in the head). If this is the case then the test is stopped and an exercise rehabilitation plan can be initiated (20 mins/day at 80% of heart rate threshold). The test is repeated at regular intervals and the exercise plan is progressively increased until exertion no longer triggers a symptomatic threshold.
If you are able to successfully complete the Buffalo Concussion Treadmill Test (exercise to exhaustion) with no increase in your symptoms, both during and for 24 hours after the test, then other causes for your symptoms should be explored. Your symptoms may be originating from your neck (cervicogenic), vision/balance disturbance or migraines and should be assessed further.
The active rehabilitation approach based on the Buffalo Concussion Treadmill Test is easy to implement and can significantly speed up the rate of recovery in cases with persisting post concussive symptoms. If you are being told to rest and give it more time, it’s time for a second opinion.