Early intervention treatment in the first 2 weeks following concussion in adults: A systematic review of randomised controlled trials.

Autor: Moore S; Physiotherapy Department, The University of Melbourne, Parkville, Victoria, Australia. Electronic address: sonya.moore@unimelb.edu.au., Musgrave C; Physiotherapy Department, The University of Melbourne, Parkville, Victoria, Australia., Sandler J; Physiotherapy Department, The University of Melbourne, Parkville, Victoria, Australia., Bradley B; Physiotherapy Department, The University of Melbourne, Parkville, Victoria, Australia., Jones JRA; Physiotherapy Department, The University of Melbourne, Parkville, Victoria, Australia; Physiotherapy Department, Division of Allied Health, Austin Health, Heidelberg, Victoria, Australia; Institute of Breathing and Sleep, Heidelberg, Victoria, Australia.
Jazyk: angličtina
Zdroj: Physical therapy in sport : official journal of the Association of Chartered Physiotherapists in Sports Medicine [Phys Ther Sport] 2024 Jan; Vol. 65, pp. 59-73. Date of Electronic Publication: 2023 Dec 03.
DOI: 10.1016/j.ptsp.2023.11.005
Abstrakt: Objective: International guidelines support a repertoire of therapeutic interventions that may assist recovery following concussion. We aimed to systematically review the efficacy of early pharmacological and non-pharmacological interventions initiated within two weeks of injury on symptoms and functional recovery of adults with concussion.
Methods: We conducted a Systematic Review (SR) of Randomised Controlled Trials (RCTs) without meta-analysis utilising the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was performed of four databases. Study inclusion criteria were adult participants diagnosed with concussion and commencing active intervention within 14 days of injury.
Results and Conclusions: Of 7531 studies identified, 11 were included in the final review. Six studies were rated as high-risk of bias, three with some concerns and two as low-risk of bias. We found no evidence to support specific pharmacotherapeutic management to hasten the natural recovery time-course. Two studies reported significant improvement in selected concussion symptoms following manual therapy (at 48-72 hours post-treatment) or telephone counselling interventions (at 6 months post-injury). No high quality RCTs demonstrate superior effects of early therapeutic interventions on concussion recovery in the first 2 weeks. We advocate future research to examine impacts of health-clinician contact points aligned with symptom-specific interventions.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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