Concussion rest time5/20/2023 ![]() ![]() Summary of Search, “Best Evidence” Appraised, and Key Findings 5 Although several governing bodies 1, 2 have recommended cognitive and physical rest following SRC, it is imperative for researchers to investigate viable postconcussion treatment strategies to appropriately manage symptoms and facilitate positive outcomes following SRC in the acute phase. 3, 4 Physical activity during the subacute phase (≥6 wk following diagnosis) has been explored as a potential intervention to facilitate physical and psychological recovery from SRC as well as to improve academic outcomes in young athletes experiencing prolonged recovery. Emerging literature has indicated that prolonged periods of physical rest may be detrimental to SRC symptom recovery. 1, 2 Despite the widespread practice of prescribing rest following SRC, there remains a paucity of evidence supporting rest as an effective intervention. 1 Physical rest recommendations consist of refraining from physical activity until the postconcussive symptoms have subsided, followed by progressive restoration of physical activity as long as the athlete is asymptomatic. Cognitive rest may include restricting daily living activities, such as school attendance, that may aggravate the symptoms. 1 More recently, rest has been divided into cognitive and physical components. 1 For the past several decades, physical rest has been prescribed as a mainstay for SRC management. An individualized approach to manage each athlete’s unique symptom phenotype is necessary to prevent a protracted recovery. Strength of Recommendation: Using Centre for Evidence-Based Medicine 2011 level 3 evidence and higher, the results suggest that early physical activity during the acute phase of a concussion may decrease symptom duration however, a lack of high-quality studies and inconsistent interventions are limitations to this recommendation.Īthletes diagnosed with sports-related concussion (SRC) have varied and complex clinical presentations that may result in symptoms that may hamper the professional, academic, or family life of athletes. Clinical Bottom Line: Current evidence suggests that early physical activity in the acute phase following a concussion may decrease the time needed for symptom resolution compared to immediate rest. Three studies were observational studies that directly compared baseline measurements to follow-up assessments. Two studies employed control groups and compared strict or recommended rest to early activity or limited rest. ![]() All 5 studies utilized follow-up time points compared to initial examination, but there was variance in the specific time points reported. Clinical Question: Does early physical activity decrease postconcussion symptoms compared to physical rest following concussion? Summary of Key Findings: A total of 5 articles were included that examined symptom duration changes at multiple time points. Recent literature suggests that early physical activity may be beneficial in reducing concussion symptoms which may influence clinical recovery time. Clinical Scenario: Currently, rest following concussion serves as the keystone of concussion treatment, but substantial evidence to support it is lacking.
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