Early school return could help children recover from concussions
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Key takeaways:
- Traditional concussion treatment calls for physical and cognitive activity restrictions.
- Cognitive activity could also benefit a patient’s recovery, researchers found.
Returning to school early may speed children’s recovery from concussion, according to study findings published in the British Journal of Sports Medicine.
“The traditional treatment for kids with concussions was to restrict their physical and cognitive activity, thinking that would help them heal faster,” Thomas Pommering, DO, division chief of sports medicine and director of concussion clinics at Nationwide Children’s Hospital, told Healio.
“It turns out that that probably is only appropriate for some of the most affecting concussions, whereas it looked like this actually might be making them feel slower because they had all this downtime and they had time to think about their symptoms,” Pommering said.
Rather than restricting their activity, Pommering said patients “should be allowed to do more.”
“We need to give patients and families better advice,” he said.
Pommering and colleagues prospectively assessed data from 83 patients, 84% of whom sustained their concussion during sports. Patients filled out questionnaires to quantify their concussion symptoms.
In the questionnaires, patients reported an average of 191 (SD = 148), 166 (SD = 151) and 38 (SD = 61) minutes of low-intensity, moderate-intensity and high-intensity daily cognitive activity after concussion while still experiencing symptoms.
Any 10 standardized minutes per hour increase in moderate-intensity or high-intensity cognitive activities after concussion was associated with a 22% greater rate of symptom resolution (adjusted HR = 1.22; 95% CI, 1.01-1.47), whereas every extra day’s delay in returning to school after concussion was associated with an 8% lower rate of symptom resolution (aHR = 0.92; 95% CI, 0.85-0.99).
“The kids would tell us, as their concussion progressed one way or the other, how much physical activity they were doing and how much cognitive activity they were doing,” Pommering said. “It turns out, kids are pretty good at self-regulating their activity — in other words, as they feel better, they'll do more.”
Additionally, the researchers found that limiting moderate-intensity activities involving significant screen time — such as video games or social media — during the first week after injury could help.
“What surprised us a little bit is kids tolerated more cognitive activity than we really knew,” Pommering said. “They can self-regulate and do as much as they feel comfortable doing.”
References:
Yang J, et al. Br J Sports Medic. 2024;doi:10.1136/ bjsports-2023-107601.
Study finds adolescents with concussion may benefit from more activity earlier. https://www.nationwidechildrens.org/newsroom/news-releases/2024/02/yang_pommering_concussionstudy. Published Feb. 12, 2024. Accessed Feb. 12, 2024.
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