October 07, 2025 | Brian Werner, PT
Kevin, an 18-year-old football player, knows all too well the frustration of concussion recovery. After sustaining his second concussion in the past year, he is filled with anxiety and uncertainty. His first experience with post-concussion syndrome was a gruelling three-month ordeal filled with setbacks and limitations. Now, facing another concussion, he is desperate to avoid a repeat of that agonising journey.
Kevin’s primary symptom is exertion-based dizziness, a common complaint among concussion patients. This dizziness was further confirmed by the Buffalo Concussion Treadmill Test, which revealed that his symptoms were linked to an underlying autonomic dysfunction. Traditional rest-based protocols have not provided the relief he needs. He has heard whispers of a new approach, a technology that might offer a faster, more targeted path to recovery: the AlterG Anti-Gravity Treadmill®.
Initially designed for orthopaedic rehabilitation, this cutting-edge device is now being explored for its potential in concussion management. By allowing for precise unweighting and controlled loading, the AlterG offers a unique opportunity to address the specific challenges individuals like Kevin’s face. Could this be the key to helping him overcome his dizziness and safely return to the sport he loves?
In this article, we will delve into the science behind the AlterG treadmill, explore its potential benefits for concussion rehabilitation, and discuss how this technology could revolutionise how we manage this complex condition. The potential of the AlterG to revolutionise concussion management should spark excitement and optimism among healthcare professionals, physiotherapists, and researchers.
Understanding the Balance System and Sensory Mismatch
To appreciate how the AlterG can help, it is essential to understand how our balance system works. It is a complex interplay of information from our inner ear (vestibular system), eyes (visual system), and body (somatosensory system). These systems work together seamlessly, but a concussion can disrupt this delicate balance, especially when the vestibular system is injured.
A dysfunctional vestibular system can send inaccurate signals to the brain, creating a sensory mismatch. This mismatch can lead to dizziness, vertigo, and nausea. It can also trigger autonomic dysfunction, causing problems regulating heart rate and blood pressure, especially during physical activity. This is why Kevin experiences exertion-based dizziness.
The Challenge of Dosage Control and the AlterG Solution
Traditional concussion management often involves a gradual return to activity, but finding the right “dose” of exercise can be challenging. Too much can worsen symptoms, while too little can hinder recovery. This is especially true for individuals like Kevin, who experience exertion-based dizziness and other symptoms related to vestibular dysfunction.
The vestibular system in the inner ear plays a crucial role in balance and spatial orientation. It senses head movements and accelerations, sending signals to the brain to help us maintain equilibrium. However, when the vestibular system is injured, as is common in concussions, it can become overly sensitive to these movements and accelerations. This can lead to dizziness, nausea, and difficulty with balance, especially during activities involving head position or speed changes.
This is where the AlterG Anti-Gravity Treadmill offers a unique advantage. Allowing for precise unweighting reduces the gravitational forces on the body, effectively lessening the load on the vestibular system. Unweighting is like taking some weight off your shoulders, making moving easier. Imagine a figure skater spinning on ice. With arms outstretched, their rotation slows; as they pull their arms in, they spin faster. This is due to the angular momentum concept, where mass distribution changes affect rotational speed. Similarly, by reducing the effective body weight, the AlterG alters the body’s mass distribution, minimising the torques and forces acting on the vestibular system during movement.
- Reduced Vestibular Strain: With less gravitational pull, the vestibular system experiences reduced strain during head movements and accelerations. This can help alleviate dizziness and other vestibular-related symptoms, allowing patients to exercise without triggering discomfort.
- Controlled Exposure: The AlterG allows gradual and controlled exposure to movement and exercise. Physiotherapists can carefully challenge the vestibular system without overwhelming it by starting with a higher level of unweighting and progressively decreasing it as the patient tolerates. This graded exposure helps the system adapt and recalibrate, promoting recovery and reducing sensitivity.
- Improved Exercise Tolerance: By minimising vestibular strain, the AlterG enables patients to exercise more without triggering symptoms. This can improve cardiovascular fitness, strength, and overall functional capacity, essential for a triumphant return to activity.
AlterG: Precision Dosage Control for Concussion Rehab
As mentioned, the AlterG allows for precise unweighting, reducing the gravitational forces acting on the body. This unweighting has several key benefits for concussion rehabilitation:
- Controlled Cardiovascular Exercise: Patients can exercise without the full impact of their body weight, minimising the risk of exacerbating symptoms.
- Gradual Reintegration of the Autonomic System: By carefully controlling the intensity and duration of exercise on the AlterG, physiotherapists can gradually challenge the autonomic nervous system, helping it to re-regulate and improve its response to exertion.
- Reduced Stress on Sensory Systems: The reduced gravitational forces also lessen the strain on the vestibular (balance) and visual systems, often affected by concussions. This can help alleviate dizziness and other sensory-related symptoms.
- Customised Exercise Dosage: The AlterG allows for precise control over the level of unweighting, enabling physiotherapists to tailor the exercise dosage to each patient’s needs and tolerance.
While research specifically on the use of AlterG in concussion rehabilitation is ongoing, studies in other neurological populations provide compelling evidence for its benefits. For instance, research has shown that AlterG training can improve balance and gait parameters in patients with chronic stroke (Cherise et al., 2015), enhance gait speed and dynamic balance in individuals with Parkinson’s disease (Carvallo et al., 2020), and increase walking endurance and balance in people with multiple sclerosis (Melbourne et al., 2017). These findings suggest that the ability of the AlterG to facilitate controlled exercise and reduce stress on the nervous system can also translate to improved outcomes for concussion patients.
Kevin’s Journey with the AlterG
Under the guidance of his physiotherapists, Kevin began a carefully structured program on the AlterG treadmill. Starting with a significant level of unweighting, he gradually progressed to walking and light jogging as his symptoms allowed. The controlled environment of the AlterG enabled him to push his limits without triggering his dizziness.
Over time, Kevin’s autonomic system began to adapt, and his exertion-based dizziness subsided. He gradually increased his activity levels and eventually returned to football training, feeling confident and symptom-free.
The Future of Concussion Management
While more research is needed to understand the potential of AlterG treadmills in concussion rehabilitation fully, early results and studies in other neurological populations are promising. The evidence suggests that the unique capabilities of the AlterG can translate to improved outcomes for concussion patients, particularly those with autonomic dysfunction and balance difficulties. Moving ‘beyond rest’ and embracing innovative tools like the AlterG can accelerate recovery, reduce the burden of post-concussion syndrome, and help individuals like Kevin safely return to the activities they love.
References
- Carvallo, A., Corcos, D. M., Horak, F. B., & Almeida, Q. J. (2020). The effects of an anti-gravity treadmill training program on gait and dynamic balance in patients with Parkinson’s disease. Gait & Posture, 75, 130-136.
- Cherise, L., Bagwell, J., Powers, C., Fisher, B., & E. (2015). Pressure-controlled treadmill training in chronic stroke. Journal of Neurologic Physical Therapy, 39(2), 127-133.
- Melbourne, A., Butler, J., Gear, R., & Coote, S. (2017). The effect of body weight supported treadmill training on walking performance and function in people with multiple sclerosis. Disability and Rehabilitation, 39(17), 1713-1720.