After a TBI, Is Resting until Symptoms Disappear the Best Medicine?July 5, 2017
When children and teens sustain concussions (a mild form of traumatic brain injury, TBI), medical professionals typically recommend rest until symptoms subside.
A recent Canadian study1 may have thrown these recommendations into question, however. That’s because the findings of this study seem to indicate that engaging in some physical activity in the days following a concussion could reduce post-concussive symptoms and improve prognoses.
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A Closer Look at the Concussion Study & its Findings
The study, entitled Association between Early Participation in Physical Activity Following Acute Concussion and Persistent Postconcussive Symptoms in Children and Adolescents, focused on 2,413 participants ranging in age from 5 to 18 years old. All subjects had suffered acute concussion.
Of the participants:
- About 70 percent (1,677 participants) engaged in some kind of physical activity within the first 7 days following injury. Physical activities included sports-related exercise, aerobic activities, and non- and full-contact practice.
- Just over 30 percent (736 participants) rested for the first 7 days after sustaining a concussion.
At 7 and 28 days following injury, both groups were given a detailed questionnaire to evaluate the extent and severity of their persistent post-concussive symptoms (PPCS). PPCS, which can be ongoing and/or worsening, can include both cognitive and physical symptoms arising from concussion.
At day 7, the questionnaire responses revealed that:
- Just over 31 percent of the active group (523 subjects) was no longer experiencing PPCS.
- About 48 percent of the active group (803 subjects) was still living with at least 3 PPCS.
- Nearly 80 percent of the non-active group (584 subjects) was experiencing at least 3 PPCS.
At day 28, the questionnaire responses indicated that:
- About 29 percent of the active group was still living with PPCS.
- Close to 40 percent of the inactive group still had PPCS.
Commenting on traditional recommendations to rest after concussions, Lead Study Author Dr. Roger Zemek explained, “unfortunately, most of those recommendations were not based on evidence; they were based on expert opinion only.”
In light of this study’s findings, Zemek and his fellow researchers concluded that some physical activity within a week of a concussion seems to reduce PPCS and promote faster recoveries. They hypothesized that this is likely the result of:
- “Restoring normal cerebral blood flow regulation” coupled with the “promotion of neuroplasticity mechanisms”
- Reengaging in “life-validating activities” that can combat some cognitive post-concussion symptoms, such as depression, stress and anxiety.
Zemek summed up these findings by noting that, “exercise itself can be a great medicine.” He did, however, share some warnings, cautioning that:
- The findings of this study should not be taken as a green light to immediately resume full-contact or intensive physical activity in the immediate aftermath of a concussion.
- Follow-up, randomized studies should be conducted to verify this study’s findings and, ideally, to specify the timing (and nature) of physical activity that can be beneficial for concussive children and adolescents.
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1: TBI Study published in the Journal of the American Medical Association (JAMA), December 2016