Citation

Dobney DM, Grilli L, Kocilowicz H, Beaulieu C, Straub M, Friedman D, Gagnon IJ. J. Head Trauma Rehabil. 2018; 33(3): E11-E17.

Affiliation

Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada (Ms Dobney and Dr Gagnon); Trauma Center, The Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada (Mss Grilli, Kocilowicz, Beaulieu, Straub, and Friedman and Dr Gagnon) Canadian Hospitals Injury Reporting and Prevention Program, Public Health Agency of Canada (Ms Friedman); and Department of Pediatrics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada (Ms Friedman and Dr Gagnon).

Copyright

(Copyright © 2018, Lippincott Williams and Wilkins)

DOI

10.1097/HTR.0000000000000339

PMID

28926482

Abstract

OBJECTIVE: To estimate the time frame during which initiating an active rehabilitation intervention (aerobic exercise, balance, and sport specific skills) after concussion contributed to improvement in symptoms at follow-up in children and adolescents who are slow to recover (symptoms persisting beyond 2 weeks) from concussion. SETTING: Concussion clinic at a tertiary care pediatric teaching hospital. PARTICIPANTS: A total of 677 children and adolescents with concussion aged 7 to 18 years.

DESIGN: Case series of participants starting active rehabilitation less than 2, 2, 3, 4, 5, or 6 or more weeks postconcussion. MAIN MEASURE: Symptom severity measured by the 22-item Post-Concussion Scale (PCS)-revised.

RESULTS: All patients experienced significant improvement of symptoms while participating in active rehabilitation, irrespective of the start time postonset. Patients initiating active rehabilitation at 2 (P <.001) or 3 (P =.039) weeks postinjury demonstrated lower symptom severity at follow-up than those starting at 6 weeks or later. Patients starting at 2 weeks had lower symptom severity than patients starting less than 2 (P =.02), 4 (P =.20), or 5 weeks postinjury (P =.04). Lastly, patients starting less than 2 and 6 weeks or more postinjury yielded equivalent outcomes.

CONCLUSIONS: The findings support the use of active rehabilitation in children and adolescents who are slow to recover from concussion. Participants starting active rehabilitation less than 2 weeks and up to 6 or more weeks postconcussion demonstrated significant symptom improvements, but improvement was observed in all groups, regardless of the time to start active rehabilitation.

Language: en