Concussion symptoms for children under 13 years old typically last three times longer than they do for older teens and adults, but keeping them out of the classroom during recovery is not necessarily the preferred treatment, according to a comprehensive research review in The Journal of the American Osteopathic Association.
Parents should be aware that significant changes in the treatment of concussion—including a major shift to promoting active recovery—have emerged in recent years, said Hallie Zwibel, DO, Director of Sports Medicine at New York Institute of Technology College of Osteopathic Medicine, and lead researcher on this study.
“It used to be thought that rest was best for a concussion. Kids were told to stay home from school and sit in a dark room for two weeks,” says Dr. Zwibel. “Now we encourage them to get back to school after two days and progressively get more active, so long as symptoms don’t return or worsen.”
The article also cites children’s vulnerability to prolonged symptoms due to underlying conditions, including ADHD, depression, anxiety and stress. Study authors hope their findings can help parents manage expectations and know their best options for treatment.
“It’s important parents understand that symptoms persist in kids for about four weeks on average,” says Dr. Zwibel. “This can be alarming and feel like a long time, especially compared to adults whose symptoms last closer to a week, but it is well within a normal recovery time.”
Researchers say rehabilitation has also proven effective for mitigating symptoms such as dizziness and changes in vision, like difficulty with focus. This includes engaging in visual and vestibular exercises, which assist with balance and spatial orientation. Therapy can help the brain to establish new neurologic pathways to regain function or to bypass disturbing signals.
While active recovery has emerged as the standard of treatment, Dr. Zwibel says athletes should not compete while they are experiencing concussion symptoms. Brain swelling and death can result if an athlete receives a concussive blow while recovering from an earlier concussion. However, getting young athletes to stay off the field during recovery remains a challenge, Dr. Zwibel noted.
“There’s not a good administrative structure to prevent an injured high school athlete from playing for another league,” says Dr. Zwibel. “At this point, parents are in the best position to prevent that and we strongly encourage them to follow return-to-sport protocols.”
Dr. Zwibel also encourages youth sports leagues to adopt and implement these standardized guidelines and seek medical providers’ input when establishing policies and practices.
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