Cognitive Rest Benefits Concussion Recovery

Cognitive rest after a concussion has a beneficial effect on recovery, according to the results of a recent prospective cohort study. Recommendations regarding cognitive rest after sustaining a concussion have been inconsistent due to lack of data. “This study supports the use of cognitive rest and adds to the current consensus opinion,” the authors write. To determine the effect of a person’s cognitive activity level on the duration of his or her post-concussion symptoms, researchers led by Naomi J. Brown, MD, Division of Sports Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, evaluated 335 young athletes who came to a sports concussion clinic within 3 weeks of sustaining an injury between 2009 and 2011. Most of the concussions were the result of injuries from playing ice hockey, football, basketball, or soccer. The age of the participants ranged from 8 to 23 years (mean age, 15 years). Patients were instructed to complete a cognitive activity scale to ascertain their average level of cognitive activity since their previous visit. Researchers also recorded their symptoms using the Post-Concussion Symptom Scale. Patients were placed in the following cognitive activity groups: complete rest; minimal activity; moderate activity; and highest activity. Brown and colleagues calculated a mean Post-Concussion Symptom Scale score of 30 at the initial visit. Participants took an average of 43 days to fully recover from their concussions. Researchers found that only the participants’ total PCSS score at the initial visit and cognitive activity level were independently associated with their duration of symptoms. Patients who engaged in the highest level of cognitive activity required the longest amount of time to recover from their concussion. Those in the complete rest, minimal activity, and moderate activity groups took approximately the same amount of time to recover from their concussions, which indicates that complete cognitive rest may be unnecessary. This study is available in Pediatrics. -Meredith Edwards White Reference Brown NJ, Mannix RC, O’Brien MJ, Gostine D, Collins MW, Meehan WP 3rd. Effect of cognitive activity level on duration of post-concussion symptoms. Pediatrics. 2014 Jan 6. [Epub ahead of print]