Related Experiment Videos
The Effectiveness of Prescribed Rest Depends on Initial Presentation After Concussion
Alicia M Sufrinko1, Anthony P Kontos1, Jennifer N Apps2
1University of Pittsburgh Medical Center Sports Medicine Concussion Program, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA.
The Journal of Pediatrics
|April 3, 2017
Summary
Patients with concussion signs benefited from prescribed rest, while those with only symptoms were more likely to remain symptomatic. Individualized concussion care is crucial from the emergency department.
Area of Science:
- Neurology
- Pediatric Medicine
- Sports Medicine
Background:
- Concussion management often involves prescribed rest.
- Patient responses to rest can vary based on injury presentation.
Purpose of the Study:
- To compare the effectiveness of prescribed rest versus usual care in pediatric concussion patients.
- To determine if patients with concussion signs respond differently to rest than those with symptoms only.
Main Methods:
- Secondary analysis of a randomized controlled trial (NCT01101724) involving 11-18 year olds.
- Patients underwent neurocognitive and balance testing, with randomization to rest or usual care.
- Symptom and activity diaries were used, analyzed with 2x2 ANOVAs and nonparametric tests.
Main Results:
- A significant interaction was found between patient group and treatment arm for symptom scores at 3 days.
- Prescribed rest worsened symptoms in the 'symptoms only' group (days 1-6, 8).
- Rest improved verbal memory in the 'signs' group but not the 'symptoms only' group.
Conclusions:
- Patients with concussion signs benefit from prescribed rest, particularly for cognitive function.
- Patients with predominantly symptoms may experience prolonged symptomatology with prescribed rest.
- Personalized concussion treatment strategies should be initiated in the emergency department.