Effect of Cognitive Activity Level on Duration of Post-Concussion Symptoms
Top Cited Papers
Open Access
- 1 February 2014
- journal article
- Published by American Academy of Pediatrics (AAP) in PEDIATRICS
- Vol. 133 (2), e299-e304
- https://doi.org/10.1542/peds.2013-2125
Abstract
OBJECTIVE: To determine the effect of cognitive activity level on duration of post-concussion symptoms. METHODS: We conducted a prospective cohort study of patients who presented to a Sports Concussion Clinic within 3 weeks of injury between October 2009 and July 2011. At each visit, patients completed a scale that recorded their average level of cognitive activity since the previous visit. The product of cognitive activity level and days between visits (cognitive activity-days) was calculated and divided into quartiles. Kaplan-Meier Product Limit method was used to generate curves of symptom duration based on cognitive activity level. To adjust for other possible predictors of concussion recovery, we constructed a Cox proportional hazard model with cognitive activity-days as the main predictor. RESULTS: Of the 335 patients included in the study, 62% were male, 19% reported a loss of consciousness, and 37% reported experiencing amnesia at the time of injury. The mean age of participants was 15 years (range, 8–23) and the mean number of previous concussions was 0.76; 39% of athletes had sustained a previous concussion. The mean Post-Concussion Symptom Scale score at the initial visit was 30 (SD, 26). The overall mean duration of symptoms was 43 days (SD, 53). Of all variables assessed, only total symptom burden at initial visit and cognitive activity level were independently associated with duration of symptoms. CONCLUSIONS: Increased cognitive activity is associated with longer recovery from concussion. This study supports the use of cognitive rest and adds to the current consensus opinion.Keywords
This publication has 24 references indexed in Scilit:
- Pediatric Sports-Related Concussion Produces Cerebral Blood Flow AlterationsPEDIATRICS, 2012
- Medical Therapies for ConcussionClinics in Sports Medicine, 2011
- Sport-Related Concussion in Children and AdolescentsPEDIATRICS, 2010
- Supporting the Student-Athlete's Return to the Classroom After a Sport-Related ConcussionJournal of Athletic Training, 2010
- Consensus Statement on Concussion in Sport: The 3rd International Conference on Concussion in Sport Held in Zurich, November 2008Journal of Athletic Training, 2009
- Concussion in Sports: Postconcussive Activity Levels, Symptoms, and Neurocognitive PerformanceJournal of Athletic Training, 2008
- Summary and agreement statement of the 2nd International Conference on Concussion in Sport, Prague 2004British Journal of Sports Medicine, 2005
- Summary and agreement statement of the first International Conference on Concussion in Sport, Vienna 2001British Journal of Sports Medicine, 2002
- Dynamic changes in local cerebral glucose utilization following cerebral concussion in rats: evidence of a hyper- and subsequent hypometabolic stateBrain Research, 1991
- MECHANICS OF HEAD INJURIESThe Lancet, 1943