More Bed Rest Is Not Always Better For Kids After Concussion

Orig. Post January 5, 2015 by CBS News | Re-Post January 12, 2014

kid concussionHead injuries, particularly concussions, are a common risk for teens who participate in competitive sports. Because a concussion can have long-term health implications, many doctors are quick to recommend a prudent recovery plan. Currently, the American Academy of Pediatrics recommends any child or teen who suffers a concussion wait five days to a week before returning to activities and playing sports.

However, a new study, published Monday in the journal Pediatrics, finds that a strict 5-day period of best rest may actually do more harm than good. Researchers found that not only does the extra bed rest make little difference in the patient’s recovery, but purposefully staying out of commission for longer may actually prolong their concussion symptoms.

“If kids feel very debilitated — they’re on five days of bed rest — they’re isolated from their friends, then they’re more likely to focus on and hence report their symptoms,” CBS News medical contributor Dr. Holly Phillips told “CBS This Morning.”

For the study, the researchers followed 99 patients between the ages of 11 and 22. Half of the participants in the group were required to follow doctor guidelines for strict bed rest for five days, while the other half were instructed to rest for one to two days and then to resume normal activities.

The researchers report they didn’t find any difference in daily post-concussive symptoms between the two groups, suggesting that the extra time may not always be necessary. The researchers also found that the group that stayed out for longer didn’t have fewer concussion symptoms and some even reported having more symptoms than those who rested for just one or two days.
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However the reason for these findings remains unclear. Phillips told CBS News that lying in bed for so long could carry some risks. “There’s another phenomenon, where if you’re in bed for five days you feel weak, you feel headachy, you feel dizzy, so being in bed can actually cause some symptoms as well,” she said.

Phillips said this doesn’t necessarily mean that all kids should plan to resume normal activity just after a few days. For anyone who sustains a serious head injury, one to two days should be the minimum, especially in order to prevent exacerbating the original injury.

Each concussion is different, so some cases may require more rest. “But in general, we use 24 to 48 hours of rest to prevent serious complications,” Phillips said. “There’s one [complication] called second impact syndrome, which is where if you have a concussion and you get hit in the head again, you can suffer life-threatening brain swelling.”

“The bottom line message is to take concussion seriously, get to your doctor and figure out exactly how much the child should have before going back to regular activities,” she said. “It can vary but more rest isn’t necessarily better.”

Each year, an estimated 173,000 patients are treated in emergency rooms around the country for sports and recreation-related traumatic brain injuries. Among that group, nearly 71 percent are between the ages of 10 and 19, according to the U.S. Centers for Disease Control and Prevention.

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