Exertion Therapy-The Better Way To Treat Concussions

March 24, 2019

Lauren Fournier, PT, DPT, Vestibular Rehab Therapist


The Pied Piper of NASCAR ended his career because of concussions. Learn about his treatment and how Lauren can help you too.

The Pied Piper of NASCAR ended his career because of

Treatment for concussions has evolved over the years from “radical rest” (staying in a dark room and having little to no activity) to the current cutting edge including “exertion therapy.” This type of treatment uses personalized aerobic and strength-based exercises to rehabilitate the brain and vestibular system to return the individual to their regular day-to-day and/or sporting activities.

For example, in Earnhardt’s case, his therapy included long bouts of quickly stepping on and off a step to increase his heart rate while performing an activity that would simulate the vibration while driving. Similarly, he performed twisting motions using a weighted ball to increase his heart rate while involving rotational forces, just as he would experience with each lap of a race.

While not everyone will need to withstand the same level of forces Dale Jr. does on a regular basis, and every person has their own unique challenges, just about everyone needs to be able to walk around comfortably without experiencing symptoms. As a way to establish the severity of your condition and to determine your tolerance for exercise, one tool we utilize is the Buffalo Concussion Treadmill Test, a research-based, validated instrument, as a baseline measure for both acute concussion sufferers (once they have cleared the immediate post-concussion period when rest is in order and “vulnerable period” with heightened risk for reinjury) and those with “post-concussion syndrome” due to lingering effects from a concussion suffered years ago. This gives us a quantifiable way to measure the intensity of exercise (i.e., miles per hour) and physiological response (i.e., heart rate and blood pressure) at which a patient experiences symptoms. These variables can then be remeasured and progress tracked.

After we get a sense of a patient’s general tolerance for exercise, we can then tailor additional stresses to the demands of that person’s life. For instance, a baggage handler at Manchester-Boston will have different demands than an assembly-line worker who will have different demands from a stay-at-home parent with three young kids. Every patient is different, and every concussion is equally different, so it is important to address the specific affected areas in a way that will best suit the patient’s needs and in a way that is gradual enough to allow the brain to heal. That’s the approach I use when rehabilitating a patient with a concussion here at FPTS. I’ll tell you when to push the gas and when to pump the brakes so you can get back to your life as soon as possible and keep it that way.

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