RT Journal Article
SR Electronic
T1 Rest and treatment/rehabilitation following sport-related concussion: a systematic review
JF British Journal of Sports Medicine
JO Br J Sports Med
FD BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine
SP 930
OP 934
DO 10.1136/bjsports-2016-097475
VO 51
IS 12
A1 Schneider, Kathryn J
A1 Leddy, John J
A1 Guskiewicz, Kevin M
A1 Seifert, Tad
A1 McCrea, Michael
A1 Silverberg, Noah D
A1 Feddermann-Demont, Nina
A1 Iverson, Grant L
A1 Hayden, Alix
A1 Makdissi, Michael
YR 2017
UL http://bjsm.bmj.com/content/51/12/930.abstract
AB Aim or objective The objective of this systematic review was to evaluate the evidence regarding rest and active treatment/rehabilitation following sport-related concussion (SRC).Design Systematic review.Data sources 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.Eligibility criteria for selecting studies 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.Results 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.Summary/conclusions 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.Systematic review registration PROSPERO 2016:CRD42016039570