Karon Law Blog

Canadian Study Suggests Children May be Able to Resume Activity Sooner Following A Concussion

By Jonathan Karon

A Canadian study published yesterday (December 20, 2016) in the Journal of the American Medical Association found that children and teenagers who suffer concussions may be able to safely return to physical activities sooner than had been thought. The study followed approximately 2400 patients from ages 5 to 18 who had been treated for concussions in the Emergency Room during 2013-2015.

The study reported that a month after suffering a concussion, more of the patients who were inactive for a week after their injury had ongoing or worse symptoms compared with children who engaged in light physical activity, such as walking and swimming. This was true even for patients with three or more concussion symptoms, such as nausea, headache or confusion.

Dr. Roger Zemek, the lead author of the study, an emergency medicine specialist at Children’s Hospital in Eastern Ontario, was quoted in today’s Boston Globe regarding the limitations of the findings. “It’s still important to have caution in the immediate post-injury period.” He emphasized that in sports-related concussions players “should always be removed from play and not return that day.” They should not be allowed to resume play until cleared by a doctor. The study does suggest, however, that it may be safe for them to return earlier than had been thought. The study theorizes that resuming physical activity may increase blood flow to the brain compared to inactivity and provide psychological benefits. Dr. Zemek says further research is needed to determine the timing and type of beneficial physical activity following a concussion.

Nonetheless, as numerous studies show the significant danger of permanent damage from multiple concussions, particularly suffering a second concussion before recovering from the first, it is important that these decisions be based on patient specific advice from a qualified physician. The U.S. Centers for Disease Control and Prevention caution in their Concussion Fact Sheet for Parents http://www.cdc.gov/headsup/youthsports/parents.html “Don’t let your child return to play the day of the injury and until a health care professional says it’s OK. Children who return to play too soon – while the brain is still healing- risk a greater chance of having a second concussion. Repeat or later concussions can be very serious. They can cause permanent brain damage, affecting your child for a lifetime.”

A copy of the Canadian study can be downloaded at jamanetwork.com/journals/jama/article-abstract/2593551. A copy of the Boston Globe article summarizing its pertinent findings and quoting Dr. Zemek can be found at www.bostonglobe.com/news/nation/2016/12/20/study-suggests-strict-rest-may-not-answer-for-concussions/rZiUlw7qw6TjchVCTcGO6K/story.html