Clinical Scenario: Currently, rest following concussion serves as the keystone of concussion treatment, but substantial evidence to support it is lacking. Recent literature suggests that early physical activity may be beneficial in reducing concussion symptoms which may influence clinical recovery time. Clinical Question: Does early physical activity decrease postconcussion symptoms compared to physical rest following concussion? Summary of Key Findings: A total of 5 articles were included that examined symptom duration changes at multiple time points. All 5 studies utilized follow-up time points compared to initial examination, but there was variance in the specific time points reported. Two studies employed control groups and compared strict or recommended rest to early activity or limited rest. Three studies were observational studies that directly compared baseline measurements to follow-up assessments. Clinical Bottom Line: Current evidence suggests that early physical activity in the acute phase following a concussion may decrease the time needed for symptom resolution compared to immediate rest. Strength of Recommendation: Using Centre for Evidence-Based Medicine 2011 level 3 evidence and higher, the results suggest that early physical activity during the acute phase of a concussion may decrease symptom duration; however, a lack of high-quality studies and inconsistent interventions are limitations to this recommendation.
Landon Lempke, Abbis Jaffri, and Nicholas Erdman
Patricia R. Roby, Robert C. Lynall, Michael J. Cools, Stephen W. Marshall, Janna C. Fonseca, James R. Stevens, and Jason P. Mihalik
Key Points ▸ Consensus statements have recently moved away from strict rest following concussion. ▸ Treatments aimed at reducing initial symptom burden may reduce recovery times. ▸ Hyperbaric oxygen therapy may be an effective treatment in high school athletes. Student-athletes typically experience
Barbara Baker, Eric Koch, Kevin Vicari, and Kyle Walenta
these limitations may be attributed to the changing guidelines for concussion treatment during the postacute phase in recent years. Suggestions for Future Research Considering the shifting guidelines for concussion treatment and the limited number of studies that met the inclusion criteria of this
Steven Nagib and Shelley W. Linens
continue to explore the correlation between VRT, DHI, and gait. If VRT can normalize disrupted gait and improved gait is correlated with improved DHI scores, then VRT will be further validated and popularized as a form of concussion treatment. There are many variables and confounding factors further