Citation

Johnson RS, Provenzano MK, Shumaker LM, Valovich-McLeod TC, Welch Bacon CE. J. Sport Rehab. 2018; ePub(ePub): ePub.

Affiliation

Athletic Training Programs, A.T. Still University, Mesa, AZ.

Copyright

(Copyright © 2018, Human Kinetics Publishers)

DOI

10-1123/jsr.2015-0167

PMID

26919230

Abstract

Following concussion, it is hypothesized that cognitive activity may potentially hinder patient recovery. This is based on the theory that cognitive activity alters the metabolism of the brain, which could potentially delay the healing process of a traumatic brain injury. While the recommendation of cognitive rest is often maintained and rationalized, a causal relationship between cognitive activity and symptom duration has yet to be established. Symptom severity and duration is recorded and assessed using different outcome measurement tools such as the Post-Concussion Symptom Scale (PCSS). Return-to-play protocols for concussions are often stringent and clear in terms of the patient's return to physical activity. However, there are many discrepancies when it comes to return-to-learn guidelines that include limiting cognitive activities such as concentrating in school, playing video games, and reading. Many practitioners suggest both physical and cognitive rest for concussed patients, but this is something that may be difficult to fully implement for school-aged individuals due to the pressure and expectation to keep on top of schoolwork. Furthermore, while prescribing cognitive rest appears to pose no risk to the patient, concrete evidence of the benefits of doing so are lacking. CLINICAL QUESTION: Does the implementation of cognitive rest as part of the post-concussion management plan reduce the number of days until the concussed adolescent patient is symptom free compared to a post-concussion management plan that does not incorporate cognitive rest?

Language: en