Concussion patients may soon be provided with minimal amounts of bed rest following a new study that questioned the value of doing so, following such an injury.
Treatment for concussions usually involve a short period of rest, followed by a gradual reintroduction to normal activity for the sufferer. However, the length of this resting period has been a matter of controversy among healthcare professionals.
Resting after a concussion was believed, by many medical professionals, to be helpful to patients. These advocates argued that adolescents recovering from concussions healed faster when their brains remained largely free of stimulation. Earlier research backing this idea found evidence for this idea, but the investigation was an observational study, with limited reliability. Some physicians even recommend cocoon therapy, which involves a patient spending several days in darkness, in an effort to relax the brain as it heals.
Adolescents who experienced concussions were studied, and recovery rates were measured, including self-reporting of symptoms. In the new investigation, 88 patients who entered emergency rooms following concussions were randomly recommended to rest for up to two days, or five. After this period, patients were advised to slowly return to normal activity.
"Contrary to expectations, strict rest for five days immediately after concussion did not help teenagers get better compared to our current advice of one to two days of rest followed by a gradual return to activity," Danny G. Thomas of the Children's Hospital of Wisconsin in Milwaukee, said.
Adolescents who rested for five days following a concussion reported more symptoms than those who rested for just two days, the study found. Thomas and his team found a five-day recovery plan did not lead to improvements in balance, clarity of thinking, or other symptoms. Those adolescents placed on the longer resting plan actually reported more severe effects from the injury than those who rested one to two days. Researchers believe that missing school and other activities for an extended period could lead to depression in the adolescents, reducing their ability to heal. A lack of exercise could also play a role in longer recovery periods, the team reported.
Because patients were aware of the recommendations provided to them, the study may have been altered by the patients, as those on five-day plans may have perceived they were sicker than those given one or two days of rest.
"Ten years ago, we were doing very little management or restriction of activity, and kids were doing too much [following concussions]. I now see kids are actually being forced to do too little. The pendulum has to come back to the middle," Gerard Gioia of the Children's National Medical Center, said.
Benefits of Strict Rest After Acute Concussion: A Randomized Controlled Trial was published in the journal Pediatrics.
