@article{ref1,
title="Is there an optimal time to initiate an active rehabilitation protocol for concussion management in children? A case series",
journal="Journal of head trauma rehabilitation",
year="2018",
author="Dobney, Danielle M. and Grilli, Lisa and Kocilowicz, Helen and Beaulieu, Christine and Straub, Meghan and Friedman, Debbie and Gagnon, Isabelle J.",
volume="33",
number="3",
pages="E11-E17",
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. <br><br>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. <br><br>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. <br><br>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.<p /> <p>Language: en</p>",
language="en",
issn="0885-9701",
doi="10.1097/HTR.0000000000000339",
url="http://dx.doi.org/10.1097/HTR.0000000000000339"
}