Early return to school, activities after concussion linked to lower symptom burden
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An early return to school and other life activities following a concussion were associated with a lower symptom burden and faster recovery among children and adolescents, researchers reported in JAMA Network Open.
“There's been growing evidence over the last 7 or 8 years that prolonged rest after a concussion can be detrimental, and that a more active treatment approach is necessary. There's been very little research that has looked specifically at return to school as it relates to clinical recommendations,” Christopher G. Vaughan, PsyD, a pediatric neuropsychologist at Children's National Hospital in Washington, D.C., told Healio.
Vaughan and colleagues sought to examine the typical time to return to school following a concussion and evaluate whether an earlier return to school was associated with symptom burden 14 days postinjury.
The experts conducted an analysis of a prospective, multicenter observational cohort study from August 2013 through September 2014. Participants aged 5 to 18 years with an acute concussion, which was defined as less than 48 hours, were recruited from nine Canadian pediatric EDs.
The primary outcome was assessed by symptom burden at 14 days. In addition, the authors used propensity score analyses to estimate the relationship between the timing of return to school and symptom burden.
In total, 1,630 children (mean age, 11.8 years; 62% male) were included. Of those, 875 (53.7%) were classified as having an early return to school. The mean number of days missed increased across all age groups — those aged 5 to 7 years, 2.61 days; those aged 8 to 12 years, 3.26 days; and those aged 13 to 18 years, 4.71 days.
The authors reported that an early return to school was associated with a lower symptom burden 14 days post-concussion in children aged 8 to 12 year years and in children aged 13 to 18 years, but not in children aged 5 to 7 years.
“This study, with its large sample size and complicated statistical methodology, really highlights that the early return to school seems to have benefit for youth with concussion,” Vaughan said.