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New Study Measures Self-Paced Cognitive Activity After Concussion

Doctors generally recommend children and teens complete physical and cognitive rest until their concussion symptoms subside. Doctors also traditionally recommend a gradual return to stressful activities, such as school and sports. However, since these general guidelines are based on expert consensus rather than strong evidence, they are often disputed by researchers who want to quantify the amount of physical and cognitive activity that children and teens should engage in following a concussion.

According to researchers at the Center for Injury Research and Policy, Sports Medicine, and Emergency Medicine at Nationwide Children's Hospital, children and teens who engaged in self-paced physical and cognitive activity during the first week after sustaining a concussion didn’t experience a hastened or prolonged recovery. These findings suggest that children and teens with a concussion might have more flexibility than initially perceived to determine their own activity levels as they recover from concussions. This also means that physicians can encourage safe, non-contact, light physical activity, while also continuing to emphasize appropriate amounts of rest.

The participants in the study were between the ages of 11 and 17 years old and were seen by medical professionals within 72 hours of injury in the emergency department or a concussion clinic at Nationwide Children's Hospital. All of the participants received a physician-confirmed concussion diagnosis. Participants wore one device to measure their physical activity and sleep around the clock, and another device to measure their cognitive activity when they weren’t at school. Participants also had to complete the Post-concussion Symptom Scale and rate their daily concussion symptoms the first week after their injury.

Researchers found that although daily physical and cognitive activity increased throughout the first week after the injury was sustained, daily post-concussion symptoms in the participants decreased. Increased daily step count was associated with an increased likelihood of early symptom resolution. However, this association was not statistically significant after adjusting for acute post-concussion symptoms and other covariates.

According to the lead author of the study, Ginger Yang, Ph.D., MPH, “This study is the first to objectively measure self-paced cognitive activity during the first week post-injury.” Dr. Yang noted that “while increased physical and cognitive activity may help reduce post-concussion symptoms, reduced symptoms may also lead to increased physical and cognitive activity levels, highlighting the need for further research to better understand this bi-directional relationship." Future research in this area will provide evidence of when an individual is ready for physical and cognitive activity after concussion and what level of activity is most appropriate during the recovery process.

To read the full study, click here.

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