Rest and treatment/rehabilitation following sport-related concussion: a systematic review.
- Schneider KJ Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.
- Leddy JJ Department of Orthopaedics, SUNY Buffalo, Buffalo, New York, USA.
- Guskiewicz KM Sports Medicine Research laboratory, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
- Seifert T Norton Healthcare, Louisville, Kentucky, USA.
- McCrea M Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
- Silverberg ND Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
- Feddermann-Demont N Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
- Iverson GL Physical Medicine and Rehabilitation, Harvard Medical School; and Red Sox Foundation and Massachusetts General Hospital Home Base Program, Boston, Massachusetts, USA.
- Hayden A Libraries and Cultural Resources, University of Calgary, Calgary, Alberta, Canada.
- Makdissi M Melbourne Brain Centre, Florey Institute of Neuroscience and Mental Health - Austin Campus, Heidelberg, Victoria, Australia.
- 2017-03-26
Published in:
- British journal of sports medicine. - 2017
Concussion
mild traumatic brain injury
rehabilitation
rest
sports
treatment
Athletic Injuries
Brain Concussion
Humans
Randomized Controlled Trials as Topic
Rest
Sports
English
AIM OR OBJECTIVE
The objective of this systematic review was to evaluate the evidence regarding rest and active treatment/rehabilitation following sport-related concussion (SRC).
DESIGN
Systematic review.
DATA SOURCES
MEDLINE (OVID), CINAHL (EbscoHost), PsycInfo (OVID), Cochrane Central Register of Controlled Trials (OVID), SPORTDiscus (EbscoHost), EMBASE (OVID) and Proquest DissertationsandTheses Global (Proquest) were searched systematically.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
Studies were included if they met the following criteria: (1) original research; (2) reported SRC as the diagnosis; and (3) evaluated the effect of rest or active treatment/rehabilitation. Review articles were excluded.
RESULTS
Twenty-eight studies met the inclusion criteria (9 regarding the effects of rest and 19 evaluating active treatment). The methodological quality of the literature was limited; only five randomised controlled trials (RCTs) met the eligibility criteria. Those RCTs included rest, cervical and vestibular rehabilitation, subsymptom threshold aerobic exercise and multifaceted collaborative care.
SUMMARY/CONCLUSIONS
A brief period (24-48 hours) of cognitive and physical rest is appropriate for most patients. Following this, patients should be encouraged to gradually increase activity. The exact amount and duration of rest are not yet well defined and require further investigation. The data support interventions including cervical and vestibular rehabilitation and multifaceted collaborative care. Closely monitored subsymptom threshold, submaximal exercise may be of benefit.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO 2016:CRD42016039570.
The objective of this systematic review was to evaluate the evidence regarding rest and active treatment/rehabilitation following sport-related concussion (SRC).
DESIGN
Systematic review.
DATA SOURCES
MEDLINE (OVID), CINAHL (EbscoHost), PsycInfo (OVID), Cochrane Central Register of Controlled Trials (OVID), SPORTDiscus (EbscoHost), EMBASE (OVID) and Proquest DissertationsandTheses Global (Proquest) were searched systematically.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
Studies were included if they met the following criteria: (1) original research; (2) reported SRC as the diagnosis; and (3) evaluated the effect of rest or active treatment/rehabilitation. Review articles were excluded.
RESULTS
Twenty-eight studies met the inclusion criteria (9 regarding the effects of rest and 19 evaluating active treatment). The methodological quality of the literature was limited; only five randomised controlled trials (RCTs) met the eligibility criteria. Those RCTs included rest, cervical and vestibular rehabilitation, subsymptom threshold aerobic exercise and multifaceted collaborative care.
SUMMARY/CONCLUSIONS
A brief period (24-48 hours) of cognitive and physical rest is appropriate for most patients. Following this, patients should be encouraged to gradually increase activity. The exact amount and duration of rest are not yet well defined and require further investigation. The data support interventions including cervical and vestibular rehabilitation and multifaceted collaborative care. Closely monitored subsymptom threshold, submaximal exercise may be of benefit.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO 2016:CRD42016039570.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.1136/bjsports-2016-097475
- PMID 28341726
- Persistent URL
- https://folia.unifr.ch/global/documents/258176
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