The Globe and Mail: Prolonged Rest Actually Harmful for those Recovering from Head Injuries

CALGARY — The Globe and Mail
Published Wednesday, Apr. 26, 2017 8:07PM EDT
Last updated Wednesday, Apr. 26, 2017 8:12PM EDT

Prolonged rest is no longer the best recommendation for people who have suffered concussions, says a document published Wednesday in the British Journal of Sport Medicine, which calls for concussion sufferers to rest only a day or two then get back on their feet.

The International Consensus Statement on Concussions in Sport is an updated document on how best to deal with concussions and is expected to “have a profound impact diagnosing and treating [them],” according to one of three University of Calgary researchers who helped revise the guidelines.

Dr. Willem Meeuwisse, a sport-medicine physician at the U of C’s Faculty of Kinesiology, co-chaired last October’s fifth International Consensus Conference on Concussion in Sport. More than 400 academics from 24 countries attended the Berlin meeting. What they concluded after much research and debate marked a change in concussion treatment.

“We used to manage this injury with rest and, if they didn’t get better, more rest. Now there’s pretty good evidence that prolonged rest is actually harmful,” Meeuwisse said.

“You do need to rest but only for a couple of days, then start to work your way back to normal life. And if you’re not better in a relatively short period of time then to seek treatment because there are aspects of this injury that are quite treatable.

“One that relates to that is we’ve defined what a concussion is and we’ve partly defined what it’s not,” Meeuwisse added. “There may be a neck injury, a whiplash injury, a balance injury, an injury with the eye-movement patterns that are quite [agreeable] to rehab and there are good signs there that show early rehab is really effective. So it’s a more treatable injury than we might have thought in the past.”

While concussion sufferers are being told to be cautiously active, it is now advised that kids may take four weeks to fully recover.

Dr. Carolyn Emery, a professor in the Faculty of Kinesiology, and Dr. Kathryn Schneider, an assistant professor, contributed to the document, which was designed to help health-care providers dealing with concussed adults and children. The primary message is Recognize and Remove. To help with the recognition process, adults are being asked to carry a pocket card called a Concussion Recognition Tool, which outlines what to look for and do.

“The new tools created from this consensus are designed to assist parents, coaches, officials and players to identify athletes with a potential concussion and remove the athlete from further risk of injury,” Emery said in a news release.

While there was consensus movement in the area of treatment, there was none when it came to linking concussions to degenerative brain diseases.

As Meeuwisse acknowledged, “There’s still no scientific evidence of a cause-and-effect relationship between concussions and degenerative problems. The jury is still out on that one. There’s lots of good research going on but nothing conclusive.”

The consensus document is being supported by the International Olympic Committee, the International Ice Hockey Federation, the International Federation for Equestrian Sports, World Rugby and FIFA.

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