Buffalo Concussion Treadmill Test Explained

In this episode, we break down the Buffalo Concussion Treadmill Test (BCTT) and how clinicians are using exercise tolerance testing to identify autonomic dysfunction, symptom exacerbation, and individualized recovery thresholds after mild traumatic brain injury (mTBI). This study explored how community adults — not just athletes — responded to the BCTT after concussion, and the findings were eye-opening. Over half of participants with mTBI showed signs of exercise intolerance just one week after injury, with many experiencing worsening dizziness, headache, imbalance, and fatigue during testing. We also discuss one of the biggest paradigm shifts in concussion management: why strict rest or “cocoon therapy” may actually prolong symptoms, and why sub-symptom aerobic exercise is becoming one of the most discussed interventions in concussion rehab heading into 2026. The paper dives into autonomic nervous system dysfunction, cerebral blood flow regulation, symptom-limited exercise prescription, and why individualized dosing may matter more than generic return-to-activity timelines. For neuro PTs, sports clinicians, vestibular therapists, and rehab professionals, this episode explores why concussion rehabilitation is becoming more active, more physiologic, and more personalized than ever before.Source: DeGroot A, Huber DL, Leddy JJ, et al. Use of the Buffalo Concussion Treadmill Test in community adult patients with mild traumatic brain injury. PM R. 2024;16(8):826-835. doi:10.1002/pmrj.13132Powered by Google Notebook LM