A new study suggests that the common perception that strict rest is best for concussed patients is not only inaccurate, but that prolonged rest may actually be harmful. The Study published in “Journal Paediatrics” shows that a majority of patients who reported to Emergencies in US Hospitals during the last 10 years, were simply instructed to rest following a diagnosis of concussion. This is in keeping with current guidelines which recommend that, such patients should submit themselves to cognitive and physical rest until the acute symptoms are resolved.
The motivation for recommending long rest is to avoid re-injury occurring while the patient is recovering.
However, the evidence supporting this guideline is considered by many critics to be sparse.
This ambiguity also contributes to variations in the amount of rest recommended by Clinicians. For instance, although the consensus view recommends 24-48 hours of rest before gradually returning to activity, many Clinicians advocate “cocoon therapy,” where patients are restricted to spending several days in a darkened room.
The researchers behind the new study from the Children’s Hospital in Wisconsin – randomly assigned 88 concussed patients between the ages of 11 and 22 to follow either 5 days of strict rest or 1-2 days of rest followed by a step wise return to activity. The patients in the “strict rest” group were not allowed to attend work or school or indulge in any physical activity during their rest period.
The team found that strict rest did not lead to improved recovery in terms of symptoms, balance, or the ability to think clearly. In fact, the patients in the strict rest group displayed worse symptoms during the first 10 days after their emergency department visit than counterparts in the short rest group.
Dr William Meehan and Dr. Richard Bachur state that, taking both, the new evidence and previous research into consideration, “a recommendation of reasonable rest for the first few days after a concussion followed by a gradual resumption of work was appropriate.