Nav: Home

After concussion, rest may not always be the best medicine, experts say

November 30, 2016

November 30, 2016 - Prescribed rest--both physical and mental--is the standard treatment for concussion. But a growing body of evidence suggests that a more active, targeted approach might provide better outcomes for some patients, reports a special article in the December issue of Neurosurgery, official journal of the Congress of Neurological Surgeons (CNS). The journal is published by Wolters Kluwer.

"Matching treatments to specific symptoms, impairments, and clinical profiles may...improve recovery after concussion," according to the statement by panel of medical and other experts. While more research is needed, the panel cites emerging evidence that "multiple active rehabilitation strategies" might be more effective than simply recommending rest for every patient with concussion. Michael W. Collins, PhD, of University of Pittsburgh is lead author of the new report.

'Active and Targeted Treatments' May Enhance Recovery after Concussion

Dr. Collins and coauthors present a series of "statements of agreement" by a team of concussion experts from various healthcare disciplines as well as from sport, military, and public health organizations. The "Targeted Evaluation and Active Management" (TEAM) panel met at a conference held in Pittsburgh in 2015, sponsored by the National Football League and University of Pittsburgh Medical Center.

Conference participants indicated their level of agreement with a series of statements regarding current and evolving treatment strategies for concussion. Current approaches emphasize immediately removing the injured person from sports or other activity, followed by a prescribed period of physical and cognitive (mental) rest and gradual return to participation.

But the panel agreed that there is "limited empirical evidence" to support the effectiveness of prescribed rest--and that rest may not be the best approach for all patients. "Concussions are characterized by diverse symptoms and impairments and evolving clinical profiles," Dr. Collins and colleagues write. "[R]ecovery varies on the basis of modifying factors, injury severity, and treatments."

The panel also weighed the emerging evidence on the "TEAM approach" as an alternative to prescribed rest. Preliminary research suggests that active treatment can be started early after concussion, and that matching targeted and active treatments to the patient's clinical profile may improve recovery. For example, some patients might receive individualized management to support them in returning to school or work. Others might receive medications to treat certain concussion-related symptoms and impairments.

Yet so far, there's little high-quality research to support specific treatments or medications for concussion management. The panel highlights severe key areas for further research--especially the need for multisite, prospective studies of specific treatments across various time points after concussion.

"No single treatment strategy will be effective for all patients after concussion because of the individualized natures of the injury and its clinical consequences," Dr. Collins and coauthors write. "Research is needed on concussion clinical profiles, biomarkers, and the effectiveness and timing of treatments."

The TEAM panel hopes their experience will help to increase awareness that all concussions are not the same and that, for some patients, treatment based on individual clinical profiles might be more effective than prescribed rest. They write, "Concussion symptoms and impairments are treatable, and active rehabilitations involving a multidisciplinary treatment team may enhance recovery."
-end-
Click here to read "Statements of Agreement From the Targeted Evaluation and Active Management (TEAM) Approaches to Treating Concussion Meeting Held in Pittsburgh, October 15-16, 2015."

Article "Statements of Agreement From the Targeted Evaluation and Active Management (TEAM) Approaches to Treating Concussion Meeting Held in Pittsburgh, October 15-16, 2015" (doi: 10.1227/NEU.0000000000001447)

About Neurosurgery

Neurosurgery, the Official Journal of the Congress of Neurological Surgeons, is your most complete window to the contemporary field of neurosurgery. Members of the Congress and non-member subscribers receive 3,000 pages per year packed with the very latest science, technology, and medicine, not to mention full-text online access to the world's most complete, up-to-the-minute neurosurgery resource. For professionals aware of the rapid pace of developments in the field, Neurosurgery is nothing short of indispensable.

About Wolters Kluwer

Wolters Kluwer is a global leader in professional information services. Professionals in the areas of legal, business, tax, accounting, finance, audit, risk, compliance and healthcare rely on Wolters Kluwer's market leading information-enabled tools and software solutions to manage their business efficiently, deliver results to their clients, and succeed in an ever more dynamic world.

Wolters Kluwer reported 2015 annual revenues of €4.2 billion. The group serves customers in over 180 countries, and employs over 19,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands. Wolters Kluwer shares are listed on Euronext Amsterdam (WKL) and are included in the AEX and Euronext 100 indices. Wolters Kluwer has a sponsored Level 1 American Depositary Receipt program. The ADRs are traded on the over-the-counter market in the U.S. (WTKWY).

Wolters Kluwer Health is a leading global provider of information and point of care solutions for the healthcare industry. For more information about our products and organization, visit http://www.wolterskluwer.com, follow @WKHealth or @Wolters_Kluwer on Twitter, like us on Facebook, follow us on LinkedIn, or follow WoltersKluwerComms on YouTube.

Wolters Kluwer Health

Related Concussion Articles:

Concussion protocols often not followed during FIFA World Cup
In the 2014 soccer World Cup, concussion assessment protocols were not followed in more than 60 percent of plays in which players involved in head collisions were not assessed by sideline health care personnel, according to a study published by JAMA.
Three ways neuroscience can advance the concussion debate
While concussion awareness has improved over the past decade, understanding the nuances of these sports injuries, their severity, symptoms, and treatment, is still a work in progress.
Concussion effects detailed on microscopic level
New research has uncovered details about subcellular-level changes in the brain after concussion that could one day lead to improved treatment.
Heads up tackling program decreases concussion rates, say researchers
Consistently using a tackling education program appears to help lessen youth football concussion severity and occurrence, say researchers presenting their work today at the American Orthopaedic Society for Sports Medicine's Specialty Day in San Diego, Calif.
Women may be at higher risk for sports-related concussion than men
Women athletes are 50 percent more likely than male athletes to have a sports-related concussion, according to a preliminary study released today that will be presented at the American Academy of Neurology's 69th Annual Meeting in Boston, April 22 to 28, 2017.
Making it harder to 'outsmart' concussion tests
Concussion testing on the athletic field depends upon comparing an athlete's post-concussion neurocognitive performance with the results of a previously administered baseline test.
Soccer players with more headers more likely to have concussion symptoms
Soccer players who head the ball a lot are three times more likely to have concussion symptoms than players who don't head the ball often, according to a new study published in the Feb.
Soccer ball heading may commonly cause concussion symptoms
Frequent soccer ball heading is a common and under recognized cause of concussion symptoms, according to a study of amateur players led by Albert Einstein College of Medicine researchers.
Could better eye training help reduce concussion in women's soccer?
With the ever-growing popularity of women's soccer, attention to sports-related concussions is also a growing concern.
Brain protein predicts recovery time following concussion
Elevated levels of the brain protein tau following concussion are associated with a longer recovery period and may serve as a marker to help physicians determine an athlete's readiness to return to play.

Related Concussion Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Bias And Perception
How does bias distort our thinking, our listening, our beliefs... and even our search results? How can we fight it? This hour, TED speakers explore ideas about the unconscious biases that shape us. Guests include writer and broadcaster Yassmin Abdel-Magied, climatologist J. Marshall Shepherd, journalist Andreas Ekström, and experimental psychologist Tony Salvador.
Now Playing: Science for the People

#514 Arctic Energy (Rebroadcast)
This week we're looking at how alternative energy works in the arctic. We speak to Louie Azzolini and Linda Todd from the Arctic Energy Alliance, a non-profit helping communities reduce their energy usage and transition to more affordable and sustainable forms of energy. And the lessons they're learning along the way can help those of us further south.