• Posted February 14, 2024

Which Activities Help Kids Recover From Concussion?

A mental workout can speed teens' recovery from a concussion, especially if it takes place in the classroom.

New research shows that returning to school early after a concussion and limiting screen time help symptoms resolve sooner.

"Children and teens should be encouraged to get back to their routines and take part in activities like clubs, jobs and homework after experiencing concussion," said study co-author Dr. Thomas Pommering, director of concussion clinics at Nationwide Children's Hospital's Division of Sports Medicine. 

"But keep in mind that for some patients, prolonged screen time in non-school activities such as gaming or internet scrolling can affect recovery if it is worsening their symptoms," he added in a hospital news release.

While other studies have touted the benefits of an early return to physical activity, little has been known about how mental activity affects post-concussion outcomes. 

For this study, researchers at Nationwide Children's Center for Injury Research and Policy in Ohio looked at the intensity and duration of daily mental activities in 11- to 17-year-olds and their effect on concussion recovery.

The young people reported increases in activities such as reading, listening to music, watching TV and using the phone, as well as how much time they devoted to mental activities overall as their symptoms eased.

Clinical guidelines have recommended young people with concussions get complete physical and mental rest until symptoms are gone. The aim is to avoid re-injury and reduce demands on injured brain tissue.

But recent clinical and experimental data have shown that lengthy rest has only a modest effect on symptoms. The resulting isolation and withdrawal, meanwhile, can have unwelcome physical, social and educational effects.

"Increased time spent in the classroom, participating in some after-school activities or working a job was associated in our study with faster symptom resolution, especially for participants with lower post-acute symptom scores," said lead author Jingzhen Ginger Yang, principal investigator in the Center for Injury Research and Policy of Nationwide Children's Abigail Wexner Research Institute. 

"However, when activities involved significant screen time -- like surfing the internet or playing video/computer games -- during the first week post-injury, symptoms resolved more slowly," she added.

On average, the study found that kids returned to school about one week after a concussion. When that was delayed, symptoms lasted longer. Club activities were linked to faster recovery.

The findings were published Feb. 12 in the British Journal of Sports Medicine.

Researchers said there may be a two-way relationship between mental activity and concussion recovery: Improving symptoms spur greater levels of cognitive activity, and vice versa. 

The findings suggest that teens with less severe symptoms may benefit from moderate- to high-intensity mental activity as soon as a week after injury. Limiting, but not barring, moderate-intensity activities involving significant screen time during that first week may further help hasten recovery. Returning to school may also be beneficial.

"Having a better understanding of the appropriate 'dosing' and timing of introducing cognitive activity is critically needed for our patients," said co-author Dr. James MacDonald, a sports medicine physician at Nationwide Children's. 

"Increased engagement in the classroom during the first week post-concussion, especially for youth with lower post-concussion symptom scores, can mean symptoms resolve faster and teens get back to normal life," he added.

More information

The U.S. Centers for Disease Control and Prevention has more about concussion.

SOURCE: Nationwide Children's Hospital, news release, Feb. 12, 2024