Effect of Cognitive and Physical Rest on Persistent Postconcussive Symptoms following a Pediatric Head Injury.

Autor: Root JM; Division of Emergency Medicine, Children's National Health System, Washington, DC. Electronic address: jeremyroot1@gmail.com., Sady MD; Division of Pediatric Neuropsychology, Children's National Health System, Washington, DC., Gai J; Biostatistics and Study Methodology Division, Clinical and Translational Science Institute at Children's National (CTSI-CN), Washington, DC., Vaughan CG; Division of Pediatric Neuropsychology, Children's National Health System, Washington, DC., Madati PJ; Division of Emergency Medicine, Children's National Health System, Washington, DC.
Jazyk: angličtina
Zdroj: The Journal of pediatrics [J Pediatr] 2020 Dec; Vol. 227, pp. 184-190.e4. Date of Electronic Publication: 2020 Jul 21.
DOI: 10.1016/j.jpeds.2020.07.049
Abstrakt: Objective: To evaluate the effect of cognitive and physical rest on persistent postconcussive symptoms in a pediatric population.
Study Design: A prospective cohort study of 5- to 18-year-olds diagnosed with an acute concussion in a tertiary care pediatric emergency department was conducted from December 2016 to May 2019. Participants (n = 119) were followed over 1 month to track days off from school and sports and the development of persistent postconcussive symptoms (residual concussion symptoms beyond 1 month). Participants were dichotomized into minimal (≤2) and moderate (>2) rest, based on days off from school and sports after a concussion. Univariate and multivariable logistic regression analyses were completed to examine associations with persistent postconcussive symptoms.
Results: Of the participants in our study, 24% had persistent postconcussive symptoms. Adolescent age, history of prolonged concussion recovery, and headache at presentation were associated with higher odds of persistent postconcussive symptoms in univariate analyses. In a multivariable logistic regression model, only adolescent age was associated with increased odds of persistent postconcussive symptoms. Compared with the minimal cognitive rest group, moderate cognitive rest did not decrease the odds of persistent postconcussive symptoms (aOR, 1.15; 95% CI, 0.44-2.99). Compared with the minimal physical rest group, moderate physical rest also did not decrease the odds of persistent postconcussive symptoms (aOR, 3.17; 95% CI, 0.35-28.78).
Conclusions: Emerging evidence supports early return to light activity for recovery of acute pediatric concussion. Our study adds to this management approach as we did not find that rest from school and sports resulted in a decreased odds of persistent postconcussive symptoms.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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