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Exercise Is Medicine

Concussion Management Clinic and Research Center at the University at Buffalo are the pioneers of using sub-symptomatic aerobic exercise to safely improve recovery from concussion and have published the first randomized controlled trial showing that controlled exercise significantly reduces symptom burden and duration of recovery.

Leddy JJ, K Kozlowski, JP Donnelly, DR Pendergast, LH Epstein, and B Willer. A Preliminary Study of Sub-symptom Threshold Exercise Training for Post-Concussion Syndrome. Clinical Journal of Sport Medicine 20(1):21-27, 2010.


Leddy JJ, Baker JG, Kozlowski K, Bisson L, and Willer B. Reliability of a Graded Exercise Test for Assessing Recovery from Concussion. Clin J Sport Med 21:89-94, 2011.


Baker JG, Freitas MS, Leddy JJ, Kozlowski KF, and Willer B. Return to full functioning after graded exercise assessment and progressive exercise treatment of postconcussive syndrome. Rehabilitation Research and Practice 2012; 705309, 7 pages.


Leddy JJ and Willer B. Use of Graded Exercise Testing in Concussion and Return-to-Activity Management. Current Sports Medicine Reports 12(6):370-376, 2013.


Darling SR, Leddy JJ, Baker JG, Williams AJ, Surace A, Miecznikowski JC, and Willer B. Evaluation of the Zurich Guidelines and Exercise Testing for Return to Play in Adolescents Following Concussion. Clin J Sport Med 24:128–133, 2014.


Leddy J, Hinds AL, Sirica D and Willer B. The role of controlled exercise in concussion management. Physical Medicine and Rehabilitation PM R 8:S91-S100, 2016.


Leddy J, Baker JG, and Willer B. Active Rehabilitation of Concussion and Post-Concussion Syndrome. Physical Medicine & Rehabilitation Clinics of North America 27(2):437-454, 2016.


Leddy J, Hinds AL, Miecznikowski J, Darling S, Matuszak J, Baker JG, Picano J, and Willer B. Safety and Prognostic Utility of Provocative Exercise Testing in Acutely Concussed Adolescents: A Randomized Trial. Clin J Sports Med 28(1):13-20, 2018.


Leddy JJ, Haider MN, Ellis M, and Willer B. Exercise is Medicine for Concussion. Current Sports Medicine Reports 17(8):262-270, 2018.


Leddy JJ, Haider MN, Hinds AL, Darling S and Willer B. A Preliminary Study of the Effect of Early Aerobic Exercise Treatment for Sport-Related Concussion in Males. Clin J Sports Med 2018 (10.1097/JSM.0000000000000663).


Leddy J, Wilber C, and Willer B. Active Recovery from Concussion. Curr Opin Neurol 2018, 31:681–686 (DOI:10.1097/WCO.0000000000000611).


Leddy JJ, Haider MN, Ellis MJ, Mannix R, Darling SR, Freitas MS, Suffoletto HN, Leiter J, Cordingley DM, and Willer B. Early Sub-Threshold Aerobic Exercise for Sport-related Concussion: a Randomized Clinical Trial. JAMA Pediatrics. Published online February 4, 2019. doi:10.1001/jamapediatrics.2018.4397.


Willer BS, Haider MN, Bezherano I, Wilber CG, Mannix R, Kozlowski K, and Leddy JJ. Comparison of Rest to Aerobic Exercise and Placebo-Like Treatment of Acute Sport-Related Concussion in Male and Female Adolescents. Arch Phys Med Rehabil. 2019 Aug 1. pii: S0003-9993(19)30505-2. doi: 10.1016/j.apmr.2019.07.003. [Epub ahead of print]


Haider MN, Leddy JJ, Wilber CG, Viera KB, Bezherano I, Wilkins KJ, Miecznikowski JC, Willer BS. The predictive capacity of the Buffalo Concussion Treadmill Test after sport-related concussion in adolescents. Frontiers in Neurology. 2019; 10. PMID: 31105634


Haider MN, Johnson SL, Mannix R, Macfarlane AJ, Constantino D, Johnson BD, Willer B, Leddy J. The Buffalo Concussion Bike Test for Concussion Assessment in Adolescents. Sports Health. 2019 Nov/Dec;11(6):492-497. doi: 10.1177/1941738119870189. Epub 2019 Sep 5. PubMed PMID: 31486715; PubMed Central PMCID: PMC6822206.


Bezherano I, Haider MN, Willer BS, Leddy JJ. Practical Management: Prescribing Sub-Symptom Threshold Aerobic Exercise for Sport-Related Concussion in the Outpatient Setting. Clinical Journal of Sports Medicine Epub ahead of press 2/15/20. 10.1097/JSM.0000000000000809.


Kozlowski K, Graham J, Leddy JJ, Devinney-Boymel L, and Willer B. Exercise Intolerance in Patients with Post Concussion Syndrome. Journal of Athletic Training48:627-635, 2013.


Schneider KJ, Leddy JJ, Guskiewicz KM, Seifert TD, McCrea M, Silverberg ND, Feddermann-Demont N, Iverson GK, Hayden A, and Makdissi M. Rest and Specific Treatments Following Sport-Related Concussion: A Systematic Review. British Journal of Sports Medicine 51(12):930-934, 2017


Bezherano I, Haider MN, Willer BS, Leddy JJ. Practical Management: Prescribing Subsymptom Threshold Aerobic Exercise for Sport-Related Concussion in the Outpatient Setting. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine. 2021;31(5):465-468


Haider MN, Bezherano I, Wertheimer A, et al. Exercise for Sport-Related Concussion and Persistent Postconcussive Symptoms. Sports health. 2021;13(2):154-160.


Leddy JJ, Master CL, Mannix R, et al. Early targeted heart rate aerobic exercise versus placebo stretching for sport-related concussion in adolescents: a randomised controlled trial. The Lancet Child & adolescent health. 2021;5(11):792-799.