Evidence map›Paper›PMID 30095546›Full record

ReviewCurrent sports medicine reports2018

Exercise is Medicine for Concussion.

John J Leddy, Mohammad N Haider, Michael Ellis, Barry S Willer

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Current sports medicine reports, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 82 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
82citing papers in PubMed, 1 pooled it
16.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

82 citing papers in PubMed, 1 synthesis or guideline pooled it, 235 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Role of anxiety in exercise intolerance and autonomic nervous system dysfunction post-concussion.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
    Trial
  5. The Effect of Aerobic Exercise on Concussion Recovery: A Pilot Clinical Trial.Journal of the International Neuropsychological Society : JINS · 2021
    Trial
  6. Trial
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  8. Article
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  12. Article
  13. Article
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  15. Article
  16. Review
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22 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 2 countries.

John J LeddyUBMD Orthopaedics and Sports Medicine, State University of New York at Buffalo, Buffalo, NY.
Mohammad N HaiderUBMD Orthopaedics and Sports Medicine, State University of New York at Buffalo, Buffalo, NY.
Michael EllisPan Am Concussion Program, Section of Neurosurgery, Department of Surgery and Pediatrics, University of Manitoba, Winnipeg, Manitoba, CANADA.
Barry S WillerDepartment of Psychiatry, State University of New York at Buffalo, Buffalo, NY.
University at Buffalo, State University of New York · USPan Am Clinic · CA

Funding

University of Buffalo Clinical and Translational Science Institute - Supplement SchulyerUL1TR001412 · NCATS · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI MURPHY, TIMOTHY F · 2015 to 2024
$33.8M
Physiological mechanisms of a biomarker of recovery from concussionR01NS094444 · NINDS · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI LEDDY, JOHN JOSEPH · 2016 to 2020
$1.8M
NCATS NIH HHS UL1 TR001412NINDS NIH HHS R01 NS094444
6 · The paper itself

Abstract

Sport-related concussion (SRC) is a physiological brain injury that produces cerebral and systemic effects, including exercise intolerance. Exercise intolerance after concussion is believed to be the result of autonomic nervous system (ANS) dysfunction. Ventilation is inappropriately low for the level of exercise intensity, raising arterial carbon dioxide (PaCO2) levels. Elevated PaCO2 increases cerebral blood flow (CBF) out of proportion to exercise intensity, which is associated with symptoms that limit exercise performance. Thus, elevated exercise PaCO2 may signal incomplete recovery from SRC. This article reviews recent observational and experimental data and presents the evidence that subthreshold aerobic exercise normalizes the cerebrovascular physiological dysfunction and is "medicine" for patients with concussion and persistent postconcussive symptoms (PPCS). It discusses the systematic evaluation of exercise tolerance after concussion using the Buffalo Concussion Treadmill Test (BCTT) and reviews the utility of the Buffalo Concussion Bike Test (BCBT), the data from which are used to establish an individualized heart rate "dose" of subthreshold exercise to safely speed recovery, which also may work in the acute recovery phase after SRC with the potential to reduce the incidence of PPCS. Evaluation and treatment approaches based on the physiology of concussion suggest that exercise is medicine for concussion, potentially adding a new dimension to concussion care to help safely speed recovery and prevent PPCS in some patients.

Indexed as

Exercise TherapyAnimalsAthletic InjuriesBrain ConcussionCarbon DioxideClinical Trials as TopicDiagnosis, DifferentialExercise TestExercise ToleranceHumansPost-Concussion SyndromeRestCarbon Dioxide

Identifiers

PMID30095546
PMCPMC6089233
OpenAlexW2885318010

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.