Quicker Resumption of Exercise May Be Best for Concussions

While rest has long been the standard for treating concussions, new research shows that children who exercise within a week of injury recover faster.

Current guidelines say children who sustain sports-related head injuries should avoid returning to play — as well as all other physical activity — until all symptoms, such as headaches, are gone.

But the new study shows that children who exercise within a week of injury, regardless of symptoms, have nearly half the rate of concussion symptoms that linger more than a month.

For the study, researchers had 3,063 children between ages of five and 18 who visited hospital emergency departments in Canada answer survey questions about their level of physical activity and severity of symptoms seven, 14, and 28 days after injury.

Contrary to recommendations, most of the children — 58 percent — still experiencing concussion symptoms resumed exercising a week after being injured, according to the researchers.

More than three-quarters — 76 percent — were physically active two weeks later, the study found.

Ordinarily, discovering so many patients weren’t following strict medical guidelines might be cause for alarm, the researchers said.

But in this case, the non-compliance was associated with faster recovery, according to the study’s findings.

“Exercise within seven days of injury was associated with nearly half the rate of persistent post-concussive symptoms, or those that last beyond a month,” said principal investigator Roger Zemek, M.D., FRCPC, who directs the clinical research unit at Children’s Hospital of Eastern Ontario and serves as an associate professor in the departments of pediatrics and Emergency Medicine and Clinical Research Chair in Pediatric Concussion at the University of Ottawa.

He noted the findings echo some previous, smaller studies calling into question the benefit of prolonged physical rest following a concussion, particularly exceeding three days.

“This is the first large-scale study to provide support for the benefits of early exercise on symptom recovery following acute pediatric concussion, shifting away from conservative rest towards more active physical rehabilitation recommendations,” he said.

And while he said “we definitely don’t want patients resuming any activity that could put them at risk of re-injury, like contact sports drills or games, until they are cleared by a doctor,” he added that light aerobic activity like walking, swimming, or stationary cycling might emerge as a beneficial recommendation after further study.

More research is needed to confirm the study’s findings and to determine the best timing for return-to-play following youth concussions, according to Zemek.

In addition to lessening long-term concussion symptoms, re-introducing exercise sooner after injury could help reduce the undesired effects of physical and mental deconditioning, he added.

“If earlier re-introduction of physical activities is, in fact, confirmed to be beneficial to recovery, this would have a significant impact on the well-being of millions of children and families worldwide and cause a major shift in concussion management,” he concluded.

Source: American Academy of Pediatrics 
Young football player photo by shutterstock.