Cognitive rest can lead to faster recovery from concussion

Have you, or someone you know, ever had a concussion? Were you instructed to rest, or even to do nothing and stay in a dark room, until your symptoms subsided? These symptoms can include a headache, difficulty concentrating or remembering things, dizziness, problems with coordination, or sleep disturbances.

New research regarding cognitive rest in recovering from concussion
A single-center study at the Sports Concussion Clinic, Children’s Hospital, Boston, Massachusetts between October 2009 and July 2011 looked at the effect of cognitive activity level on the duration of post-concussion symptoms. 355 young athletes ranging in age from 8 to 23 years-years-old presented within three weeks of concussion. The median age was 15-years-old; 62% were male. Most of the concussions occurred while playing hockey, football, basketball, or soccer.

The study found that the participants who engaged the most in activities that required concentration and attention took the longest to recover from a concussion. These activities included doing homework, texting, and playing video games.

How long does it take to recover from a concussion?
In the study at the Sports Concussion Clinic, the overall mean duration of symptoms was 43 days. Participants who engaged in less cognitive activity took between 20 to 50 days to recover. Those who participated in higher amounts of cognitive activity took about 100 days on average to recover.

William P. Meehan III, MD, the lead author of the of the study told Medscape Medical News, “The study found that athletes doing mild to moderate levels of cognitive activity recovered from concussion at about the same rate as those doing minimal amounts of activity.” “It’s only those doing the highest levels of cognitive activity that tend to draw out their recovery.” The fact that athletes doing mild to moderate levels of cognitive activities had a similar duration of symptoms suggests that complete abstinence from the cognitive activity is unnecessary. Dr. Meehan stated, “Limiting the amount of cognitive activity you do to keep it below the level where you get symptoms is probably helpful, but I wouldn’t recommend just doing nothing.” The study also showed that cognitive activity affected recovery from concussion more during the earlier phase of recovery.

How important is cognitive rest after a concussion?
At the Second International Conference on Concussion in Sport in 2004, the summary statement recognized cognitive rest as “a need to limit exertion with activities of daily living and to limit scholastic activities while symptomatic.” In the consensus statement on Concussion in Sport from the 4th International Conference on Concussion in Sport held in Zurich, November 2012, it stated, “The cornerstone of concussion management is physical and cognitive rest until the acute symptoms resolve and then a graded programme of exertion prior to medical clearance and RTP.” (RTP means Return to Play). To see the full consensus statement, go to:

Future research regarding recovering from concussion
Although the Sports Concussion Clinic study has some limitations, Andrew Mayer, Ph.D., associate professor of the Mind Research Network at the University of New Mexico stated that it “provides some of the first prospective evidence that cognitive activity soon after injury may actually prolong the symptoms of a concussion.” To learn more about the Mind Research Network, go to:

The Sports Concussion Clinic study was published online in Pediatrics on 1/6/2014. For an abstract of the article, go to:

Do you have cases involving clients who have sustained a concussion? Ask how we can help give you more time to focus on the legal issues of the case.

Jane D. Heron, RN, BSN, MBA, LNCC is a legal nurse consultant at Med League. Contact us for your next case.