Concussions happen, especially to young people who are active or involved in sports. The usual treatment has been to keep the patient at home and doing nothing but rest for one or two days until they start to feel better, and then having them return to school and activities slowly. But some experts have recommended resting for longer than one or two days. Now, a randomized trial has found that more rest is not needed and may be counterproductive.
A study randomly recruited patients aged 11 to 22 who came to the pediatric emergency room at Children's Hospital of Wisconsin in Milwaukee within a day of having suffered a concussion. None had symptoms severe enough to require being admitted to the hospital. They were randomly assigned to strict rest for 5 days or to 1 or 2 days rest and a gradual return to their usual activities. They were tested for mental function, balance, and concussion symptoms in the emergency room and were asked to keep a diary to record physical and mental activities and daily symptoms.
The patients who were told to rest 5 days reported that they had more symptoms than did the ones who rested completely for only 1 or 2 days. There were no differences seen in mental function or balance.
Symptoms of concussion include headache, nausea, irritability, and a feeling of sadness. For most young people who suffer a concussion, symptoms go away over time.
The recommended treatment for a young person with a concussion has changed over recent years. Someone who hit their head during playing a sport was once left in the game unless they had severe symptoms. Recently, some neurologists recommended that a younger person with a concussion stay in a dark room for several days in what is called "cocoon therapy." This study suggests that one or two days of rest and a couple of days of taking it slow may be best. Still, anyone with a concussion should be cleared by a physician before returning to sports.
The study was published in the journal Pediatrics.