Rest is universally considered the cornerstone treatment for concussion, but a new study led by Dr. Roger Zemek, a researcher at the University of Ottawa Brain and Mind Research Institute (uOBMRI) and at the CHEO Research Institute and CHEO pediatric emergency physician, suggests that light aerobic activity following a concussion may accelerate recovery.
The new study, published today in the Journal of the American Medical Association (JAMA), enrolled over 3,000 children between the ages of 5 to 18, who were treated at emergency departments across Canada for concussions that had occurred within the previous 48 hours. Dr. Zemek’s findings go against conventional wisdom that children suffering from concussions should stay in bed and rest.
“We found that, after a concussion, children who had performed physical activity early were significantly less at risk of having prolonged symptoms when compared to children who strictly rested for that same period of time,” said Dr. Zemek.
Concussions are quite common in children and can cause a variety of physical, cognitive and even emotional symptoms, from headaches, nausea and dizziness to trouble thinking, concentrating and speaking. Some children can feel sad or anxious, be more rambunctious and even struggle with sleep. Symptoms can resolve quickly, or linger for weeks or months after the injury.
Dr. Zemek’s team measured the children’s participation in physical activities and rated the severity of concussion symptoms using standardized questionnaires one week after injury, and followed up with another assessment four weeks after enrollment. Whereas 44% of children who fully rested the first week continued to have three-or-more persistent or worsening symptoms one month following their injury, only 25% of children who had participated in physical activity within the first week following their injury experienced persistent symptoms at one month.
According to Dr. Zemek, extended rest may hamper concussion recovery because of the negative mental and physical effects associated with inactivity, which can lead to secondary symptoms of fatigue, depression and anxiety. On the other hand, light aerobic activity done in a safe manner could enhance physical, psychological and academic outcomes. However, Dr. Zemek urges caution before letting children lace up their skates or slip into their ski boots: any activity that involves a risk of collision should be avoided to reduce the risk of a second, and potentially more severe, concussion while their brain is still recovering.
Dr. Zemek is now in the process of conducting a randomized controlled trial to better understand how physical activity can help children recover from concussions. “The next steps in our research will also need to determine the ideal timing, type and duration of physical activity following concussion in order to maximize benefits of early physical activity following a brain injury,” said Dr. Zemek.
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