John J. Leddy, M.D., clinical professor of orthopedics at the Jacobs School of Medicine and Biomedical Sciences, at the University at Buffalo, State University of New York, is conducting a study on concussions that may dramatically alter the standard of care for acute concussion.
New Concussion Treatment Proposed
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Leddy said, “Until recently, the standard of care in concussion has been to tell individuals who have suffered concussions to go home and rest until the symptoms go away. Our research has demonstrated that some activity is actually necessary to promote recovery. We treat concussion rather than do nothing. We take a proactive approach to concussion.”
The goal of the trial, which focuses solely on adolescents, is to evaluate for the first time a treatment protocol for concussion. The study will test the exercise treatment on any 13- to 17-year-old adolescent who has experienced a concussion, whether or not it was the result of sports participation.
Researchers have not yet identified at what point activity becomes detrimental, but they believe that there is such a point. “We know that activity helps to speed recovery, but we also know too much activity prevents it, ” explained Barry S. Willer, Ph.D., director of research for the UB Concussion Management Clinic and professor of psychiatry, who is coordinating the research study design. “A major goal of our research is to determine how much activity, and what activity is best, ” Willer said.
Julia Whipple, a 16-year-old high school student, was one of the first to enroll and successfully complete the trial. A soccer goalie, she was injured when she collided head-on with an opponent. “When I heard that I would be allowed to continue with some exercise while I recovered, I was excited, ” she said. “I didn’t want to just go home to my bedroom and wait for symptoms to disappear.”
The program is being funded by the Ralph C. Wilson Foundation and the Program for Understanding Childhood Concussion and Stroke and managed by researchers at UBMD Orthopaedics & Sports Medicine.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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