New guidelines allow kids with mild concussions to get active after just two days

If you’ve had a child with a concussion, you know that the main treatment is rest — both physical and mental. For nearly a decade, concussions among children have required enforced rest in a dim room with no screens, books or stimulation of any kind. It isn’t easy, especially for children with a lot of energy to burn, but it was thought necessary to promote healing.

Recent research has challenged that treatment agenda, at least for mild brain trauma. The American Academy of Pediatrics (AAP) has now updated its guidelines to allow a quicker return to both physical and mental activity. In these mild cases, only a couple of days’ rest is required.

Prolonged bedrest can leave children feeling anxious and isolated. For another, a recent study indicates that kids who rested only two days after a concussion actually reported fewer symptoms and experienced a faster recovery than those who underwent a strict five-day break.

“For a child, particularly, who is all about curiosity and new experiences, who has so much more energy than their mom or dad, it’s almost like a punishment to tell them they have to stay in a dark room,” says the co-director of Stanford University’s Concussion and Brain Performance Center.

The new AAP guidelines are similar to new recommendations by the Centers for Disease Control and Prevention, and for good reason. The same team developed both sets. The upshot to both is that restrictions on activity should be personalized to each child, balancing their need for stimulation against the need for rest.

For example, doctors, parents and schools should gradually reintroduce stimuli such as schoolwork, homework and play. After two or three rest days, the child might return to school half-time. Children might be encouraged to do as little as they can — or as much as they can do without a worsening headache. Physical exercise should be reintroduced gradually.

Guidelines on screens and electronic devices have also been updated. According to a co-author of both the AAP and CDC guidelines, there is nothing inherently dangerous about looking at screens after a concussion, although too much time staring at screens could worsen post-concussion headaches.

“One thing we have to acknowledge with kids nowadays is that they are highly connected socially through their electronic devices,” he added.

Every year in the U.S., between 1.1 and 1.9 million kids are treated for sports- or play-related head injuries. Researchers suspect that many more such injuries go untreated, especially when kids don’t want to admit they’re hurt. These new guidelines should make the post-concussion rest period much easier to bear.

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