Dr. Danny G. Thomas, a pediatric emergency medicine physician at Children’s Hospital of Wisconsin, conducted a study involving the amount of rest needed by children who experienced a concussion, but were not admitted to the hospital. The currently used “cocoon” approach has been to restrict the child’s activity, return to school and overall level of stimulation for an extended period. Dr. Thomas’ study of 88 children involved prescribing either 48 hours or 5 days of cognitive and physical rest. The study has yielded interesting results. Dr. Christopher Giza, a pediatric neurologist at Mattel Children’s Hospital of the University of California – Los Angeles, commented that there was “no advantage to prolonged rest.” The Wisconsin study observed more physical symptoms in children who rest more than 5 days and more emotional symptoms like irritability and sadness in the group who rested for 10 days. The children were tested on a daily basis throughout the study using measures which include assessment of balance, a key recovery indicator.
Obviously, the children did not return to hard play or sports where they had received their concussion until they were cleared apart from the study. The study group needs to be expanded before the shorter post-concussion rest period becomes the standard of practice, but it does focus our attention on the return to school, friends and involvement in activities as important to recovery.