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Title: Rest and treatment/rehabilitation following sport-related concussion: a systematic review.
Austin Authors: Schneider, Kathryn J;Leddy, John J;Guskiewicz, Kevin M;Seifert, Tad;McCrea, Michael;Silverberg, Noah D;Feddermann-Demont, Nina;Iverson, Grant L;Hayden, Alix;Makdissi, Michael
Affiliation: Physical Medicine and Rehabilitation, Harvard Medical School; and Red Sox Foundation and Massachusetts General Hospital Home Base Program, Boston, Massachusetts, USA
The Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
Olympic Park Sports Medicine Centre, Melbourne, Australia
Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
Libraries and Cultural Resources, University of Calgary, Calgary, Alberta, Canada
Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
Department of Neurology, University Hospital Zurich, Zurich, Switzerland
Schulthess Clinic, Zurich, Switzerland
Norton Healthcare, Louisville, Kentucky, USA
Department of Orthopaedics, SUNY Buffalo, Buffalo, New York, USA
Sports Medicine Research laboratory, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
Issue Date: Jun-2017 2017-03-24
Publication information: British journal of sports medicine 2017; 51(12): 930-934
Abstract: The objective of this systematic review was to evaluate the evidence regarding rest and active treatment/rehabilitation following sport-related concussion (SRC). Systematic review. 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. 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. 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. 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. PROSPERO 2016:CRD42016039570.
DOI: 10.1136/bjsports-2016-097475
Journal: British Journal of Sports Medicine
PubMed URL: 28341726
Type: Journal Article
Subjects: Concussion
mild traumatic brain injury
Appears in Collections:Journal articles

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