The Buffalo Concussion Bike Test is a clinically validated assessment tool designed to evaluate exercise tolerance and autonomic function in individuals recovering from concussion. Similar in purpose to the Buffalo Concussion Treadmill Test, this bike-based protocol offers an alternative exertion test for patients who may have balance issues, orthopedic limitations, or other reasons that make treadmill use difficult or unsafe.

Concussions often cause dysautonomia—disruption of the autonomic nervous system—which can impair heart rate regulation, blood pressure control, and exercise tolerance. The Buffalo Concussion Bike Test systematically increases physical exertion on a stationary bike while closely monitoring the patient’s symptoms, heart rate, and physiological responses. This controlled, graded exercise helps clinicians identify the threshold at which symptoms worsen or autonomic dysfunction is evident, providing important insights into the patient’s recovery status.

During the test, the individual pedals at a constant speed with incremental increases in resistance applied every minute. Clinicians track symptoms such as dizziness, headache, fatigue, and nausea, as well as heart rate changes and blood pressure. The test is stopped if symptoms significantly worsen or if the patient reaches a pre-established maximum heart rate or exertion level. This ensures patient safety and helps prevent exacerbation of concussion symptoms.

The Buffalo Concussion Bike Test is an essential tool for sports medicine specialists, physical therapists, and other healthcare providers involved in concussion management. It provides objective data on autonomic nervous system function and aerobic capacity, which are critical for designing personalized rehabilitation plans. By understanding the patient’s exercise tolerance, clinicians can recommend safe, gradual return-to-activity protocols that minimize the risk of prolonged symptoms or re-injury.

This bike-based test is particularly useful for patients with vestibular issues, balance impairments, or musculoskeletal conditions that make treadmill testing impractical. It enhances concussion recovery monitoring, promotes safe return-to-play decisions, and supports long-term brain health by addressing the unique challenges of autonomic dysfunction post-concussion.