@article{ref1,
title="Understanding the true effect of screen time on recovery from concussion",
journal="Pediatrics",
year="2022",
author="Macnow, Theodore and Curran, Tess and Mannix, Rebekah",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="More than 2.5 million high school students sustain concussions in the United States each year.1 Adolescents spend more than 7 hours daily on screen time (ST).2 Historically, expert opinion recommended ST abstinence to various degrees, worrying that ST would be harmful to concussion recovery.3-5 Last year, we published a randomized clinical trial of concussion patients aged 12 to 25 years old, which found that those instructed to abstain from ST for the first 48 hours recovered 4.5 days sooner than those who were permitted ST.6 Our study demonstrated that early ST limitations improved time to recovery but prompted many questions regarding the dosing, timing, and mechanism of ST limitations.   In this issue of Pediatrics, Cairncross et al shed light on the effect of ST on recovery after concussion.7 Using data from a large, longitudinal cohort study of children (Advancing Concussion Assessment in Pediatrics [A-CAP]), they investigated the association of ST on self- and parent-reported symptom severity in 712 children and adolescents with concussion or orthopedic injury (OI). Applying robust statistical models to control for known predictors of concussion outcomes as well as pre- and postinjury lifestyle behaviors, the authors found that ST had a small but statistically significant nonlinear effect on worsening symptom severity of the concussion compared with the OI group. Interestingly, this effect was only significantly different between the groups for self-reported cognitive symptoms and parent-reported somatic symptoms and not for parent-reported cognitive nor self-reported somatic symptoms. It is notable that ST only accounted for 0.6% to 3.5% of the proportion of their model's total predictive ability, suggesting ST is significant but not one of the most influential factors in concussion recovery. Perhaps most important, among most of the Health and Behavior Inventory scales used in this study, there was a &quot;Goldilocks effect,&quot; demonstrating that those in the 25th to 50th percentiles had less severe symptoms than those on the higher end of ST use or those who minimally used screens.<p /> <p>Language: en</p>",
language="en",
issn="0031-4005",
doi="10.1542/peds.2022-058835",
url="http://dx.doi.org/10.1542/peds.2022-058835"
}