Elsevier

The Journal of Pediatrics

Volume 161, Issue 5, November 2012, Pages 922-926
The Journal of Pediatrics

Original Article
Efficacy of Immediate and Delayed Cognitive and Physical Rest for Treatment of Sports-Related Concussion

https://doi.org/10.1016/j.jpeds.2012.04.012Get rights and content

Objectives

To evaluate the efficacy of cognitive and physical rest for the treatment of concussion.

Study design

High school and collegiate athletes (N = 49) underwent post-concussion evaluations between April 2010 and September 2011 and were prescribed at least 1 week of cognitive and physical rest. Participants were assigned to groups on the basis of the time elapsed between sustaining a concussion and the onset of rest (1-7 days, 8-30 days, 31+ days). Main outcome measures included Concussion Symptom Scale ratings and scores on the 4 composite indices of the Immediate Post-Concussion Assessment and Cognitive Testing measure, both before and following rest. Mixed-factorial design ANOVA were used to compare changes on the dependent measures within and between groups.

Results

Participants showed significantly improved performance on Immediate Post-Concussion Assessment and Cognitive Testing and decreased symptom reporting following prescribed cognitive and physical rest (P < .001), regardless of the time between concussion and onset of rest (P = .44).

Conclusion

These preliminary data suggest that a period of cognitive and physical rest may be a useful means of treating concussion-related symptoms, whether applied soon after a concussion or weeks to months later.

Section snippets

Methods

Participants were 49 high school to college-aged individuals (range = 14-23 years; mean = 15.0, SD = 2.58) who sustained a concussion and were referred to the Sports Concussion Center of New Jersey (SCCNJ) for assessment and management between April 2010 and September 2011. Diagnosis of having sustained a concussion was consistent with the consensus definition.5 All participants were prescribed at least 1 week of cognitive and physical rest as treatment. Participants were not equally

Results

There were no between-groups differences with respect to age (P = .36), sex (P = .09), history of concussion (P = .11), or diagnosis of attention deficit disorder/learning disorder (P = .22) (Table I).

Mixed-factorial design MANOVA revealed a significant multivariate effect of prescribed rest on cognitive function and symptoms [F(5,42) = 10.63; P = .001] with no effect of time elapsed since concussion noted [F(10,86) = 1.02; P = .44]. Significant effects were noted on all 4 ImPACT composite

Discussion

A period of prescribed cognitive and physical rest is often applied as an immediate treatment for sports concussion, even though there is no empirical evidence to support such treatment. Health care professionals have been typically guided by their own judgment, as well as by position statements and policies of professional groups, in the treatment of sports concussion.5, 19, 20 Without evidence to support the case for rest, especially when weeks or months have passed since the injury,

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    The authors declare no conflicts of interest.

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