Improved Care and Prevention Improving childhood concussion care
Roger Zemek, Children’s Hospital of Eastern Ontario
Pediatric Concussion Assessment of Rest and Exertion (PedCARE); a Randomized Controlled Trial
Issue
Concussion is an injury to the brain
from a blow or shaking of the head. Concussion rates in children have
quadrupled since 2003, representing approximately 30,000 doctor visits/year in
Ontario. Research has shown that children are at higher risk of sustaining a
concussion than adults and take longer to recover.
Physical symptoms (headache, nausea, dizziness), memory and concentration
problems, and emotional/behaviour changes are common after a
concussion. Disturbingly, one-third of children who sustain a concussion
experience these symptoms for months, and some even for years. When symptoms
last at least one month, it is known as Persistent post-Concussion Symptoms
(PCS). PCS has tremendous negative effects on quality of life and can affect
school attendance and performance, and reduce social contact with friends and
peers due to removal from sports and recreational activities. In teens,
Persistent post-Concussion Symptoms may increase the risk for drug and alcohol
abuse, the risk for long-term mental health problems and suicide.
In the hope of preventing this
condition, current concussion management calls for both physical and mental
rest. However, recent research suggests that too much rest may delay the
brain’s recovery. Restarting physical activity early has proven physical and
mental benefits in many other conditions such as stroke (a severe brain
injury). Although this may also be true for concussion, it has not yet been
studied.
Project
Research is urgently needed to determine the ideal balance of physical rest and exertion. This project will examine whether restarting exercise (beginning with a walking program) at three days following a concussion is associated with better recovery compared to current protocols. It is believed that earlier physical activity in children after concussion may reduce the risk of PCS, result in better quality of life, and a successful return to school and sports performance.
