Kids with concussions can phase in activity in a few days

Pediatricians walk back the ‘7 days of rest’ precaution

In the old days, concussions in children were not taken seriously or not properly treated. Shake it off. Get back out there. As the long-term effects of brain injury became known, doctors went to the other extreme. They advised a full week of rest, in a dark room with no physical or mental stimulation.

Now pediatricians and the CDC are saying that it’s safe for kids to resume some activity within a few days. In fact, children who rest just two days may recover faster than those who sit out for a full week.

Pendulum swings back on protocol for child concussions

For the past decade or more, the medical consensus on concussions in children was to isolate kids for a solid week. No sports or strenuous activity. No TV or video games. Even books and homework were thought to be too taxing for the recovering brain. This is torture for children. Doing nothing for five days is boring and difficult. And it may actually be detrimental, or at least needlessly conservative.

This fall, the American Academy of Pediatrics updated the concussion guidelines for youths and young children. They are now advising that kids can ease back into activity sooner after a concussion injury.

• Kids should lay low for the first two days. Lots of rest. Low light. Little or no screen time. Reprieve from homework.
• After two days, phase in activity. Light exercise. A few hours of electronics or TV. Back to school if they feel up to it. Homework if it’s not too taxing. Get good sleep.
• Within a week, most kids can resume normal life, including rigorous physical activity and strenuous mental activity such as homework and school exams. It may be advisable (or required) to see a doctor before rejoining sports practice.

A full week of rest is unnecessary for most kids

A concussion is a form of traumatic brain injury. The effects of concussion can be long-lasting and the multiple concussions have a cumulative effect. It’s impossible to pinpoint the extent of damage without brain scans or intensive neurological testing. So doctors have taken a cautious approach to prevent long-term damage. Maybe too cautious.

A recent study of youths and young adults (age 11 to 22) who had suffered concussions found that five days of strict rest was unnecessary. Researchers found no health benefit to “laying low” for a whole week. In fact, the group that rested longer reported more symptoms over 10 days and, on average, slower recovery.

Concussion care should be tailored … and closely monitored

The new guidelines advise an individualized approach to concussions. If the child seems ready to resume activity, they should be allowed and encouraged to do so. They should still get rest and be monitored for the first two days after a concussion. If the child becomes fatigued or dizzy, or struggles with memory or concentration, more rest is indicated.

Take the child to the doctor if the symptoms persist or worsen. Seek emergency treatment for severe symptoms: headache, vomiting, convulsions, one dilated pupil, slurred speech, can’t wake up, etc.