• Thursday, January 09, 2014RSS Feed

    Lack of Cognitive Rest Can Impede Concussion Recovery

    A new study supports the consensus view that for young people recovering from concussions, too much cognitive activity too soon can actually slow the return to normal functioning.

    The findings are reported in the January 6 issue of Pediatrics (abstract only available for free), and involved reports on cognitive activity over a series of visits on 335 patients aged 8-23 who suffered a concussion. The study group was composed of 62% males with 19% of the entire group reporting loss of consciousness and 37% reporting amnesia at the time of injury. Mean duration of symptoms was 43 days.

    Researchers divided the participants into quartiles based on self-reports of cognitive activities between visits. The ratings ranged from "minimal cognitive activity" (no reading, no homework, fewer than 5 text messages per day, fewer than 20 minutes per day of screen-based activity) to "full cognitive activity" (no restrictions on cognitive activity). The study revealed that the participants who reported full cognitive activity soon after concussion had a markedly slower recovery rate than those who restricted higher-level mental work.

    Authors noted that the differences occurred only between the most active quartile and the rest, and were not graduated based on the levels reported. "This seems to suggest that while limiting cognitive activity is associated with shorter duration of symptoms, complete abstinence from cognitive activity may be unnecessary," the authors wrote, adding that the study seems to indicate that the negative effects of cognitive activity appear to take place during the earlier phases of recovery.

    Physical therapists (PTs) play an important role in the treatment of individuals who have suffered concussions. Get the latest information on these injuries and what’s being done to reduce them at the APTA traumatic brain injury webpage.


    Comments

    Thank you for posting this article. I would agree that in the early phases post-concussion, cognitive as well as physical rest is very important to facilitate recovery. Our present understanding of the neurometabolic cascade or "energy crisis" that occurs post-concussion, demonstrates that the brain demands energy to heal. If the brain is deprived of energy via cognitive or physical stress, healing can be delayed. The younger patient may need to consider resting longer given normal development of the brain. However at some point, the individual needs to initiate cognitive and physical stress to facilitate recovery. This is supported by the research of Griesbach et al.. As physical therapists, we are uniquely positioned to help those individuals who have protracted symptoms and delayed recovery. Research by Alsalaheen et al., provide evidence for the role of physical therapy in post-concussion management. -Paul
    Posted by Paul Vidal on 1/10/2014 5:47 PM
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