New Data Supports Importance of Cognitive Rest for Concussion Recovery
Most current guidelines recommend “cognitive rest” during the initial stages of recovery from concussion. “Cognitive rest” involves limiting activities that require attention and concentration such as reading, doing homework, text messaging, playing video games, working online, watching movies and television and listening to music. Cognitive rest has been recommended in the past based on somewhat limited evidence suggesting that failing to minimize these activities in the early stages following a concussion could delay recovery. Strong additional evidence supporting the importance of cognitive rest for concussion recovery can be found in the February 2014 issue of Pediatrics, published by the American Academy of Pediatrics. Naomi Brown, et. al. report the results of a study involving 335 patients with concussions. They found that those engaged in the highest levels of cognitive activity following injury had the longest times to symptom resolution.
This study adds empirical support to the practice of putting in place academic accommodations for student- athletes suffering from sports related concussions. The study found that limiting cognitive activity during the earlier phases of recovery made a greater difference than in later phases, supporting a gradual return to cognitive activity tied to the resolution of acute symptoms (similar to the return to physical activity discussed in earlier posts.)
Cognitive rest for concussion recovery is recommended in the consensus statement arising from the Fourth International Conference on Concussion in Sport. This statement recommends further research, a need met in the Brown study. Cognitive rest is also recommended in other current guidelines, including those from the American Academy of Pediatrics, the American Medical Society for Sports Medicine, the American College of Sports Medicine, and the American Academy of Neurology.