Journal CME, December 2023: Consensus statement: An evidence-based review of exercise, rehabilitation, rest, and return to activity protocols for the treatment of concussion and mild traumatic brain injury-Journal CME, December 2023: Consensus statement: An evidence-based review of exercise, rehabilitation, rest, and return to activity protocols for the treatment of concussion and mild traumatic brain injury

Journal CME, December 2023: Consensus statement: An evidence-based review of exercise, rehabilitation, rest, and return to activity protocols for the treatment of concussion and mild traumatic brain injury

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A systematic review was conducted to evaluate the effectiveness of therapeutic interventions for concussion and mild traumatic brain injury (mTBI). The review focused on rest, exercise, rehabilitation, and return to activity protocols. Results showed that exercise therapy was recommended for adolescents with acute concussion/mTBI, but the evidence for other age groups and therapeutic modalities was limited and inconsistent. Strict rest and high-intensity physical activity were found to have negative effects. Overall, most interventions were considered safe when used carefully and tailored to individual patient needs. The review emphasized the need for high-quality studies to evaluate the effects of rest, rehabilitation, and return to activity protocols for concussion/mTBI management.<br /><br />The role of rest in improving outcomes for concussion patients remains uncertain. While some studies suggest cognitive and physical rest may help, others show no benefit or even detrimental effects. The evidence on exercise therapy, particularly for adolescents with acute concussion/mTBI, was more positive, but the evidence for other age groups and interventions is limited and of varying quality.<br /><br />A consensus statement based on the systematic review provided evidence-based recommendations for exercise, rehabilitation, rest, and return to activity protocols for concussion and mTBI. It highlighted the importance of individualized care, the need for further research, and the use of clinical judgment when selecting interventions. While exercise was deemed appropriate for adolescents with acute concussion, uncertainty remains regarding its effectiveness for other age groups. Similarly, the evidence for other interventions, like cognitive rehabilitation and vestibular rehabilitation, is inconclusive.<br /><br />Clinicians are encouraged to consider the available evidence, patient preferences, and values when choosing interventions for concussion patients. It is crucial to stay up to date with new research in this evolving field.

Keywords

systematic review

therapeutic interventions

concussion

mild traumatic brain injury

rest

exercise

rehabilitation

return to activity protocols

adolescents

acute concussion