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Challenging the dogma that ‘rest is best’ after concussion (Commentary on Mychasiuk et al.)


Clinical management of concussions or mild traumatic brain injuries (mTBI) is currently guided by expert‐derived consensus statements (Giza et al., 2013; McCrory et al., 2013; Graham et al., 2014). At present, concussed patients are advised to undergo an initial post‐injury period of physical and cognitive rest, until asymptomatic at rest and able to return to maximal exercise without symptom exacerbation. This conservative standard of care is in line with the Latin concept of primum non nocere, or ‘first, do no harm,’ and has been widely accepted particularly for brain injuries in children and adolescents, who may be more susceptible to the potential lasting consequences of concussion (Graham et al., 2014). However, such guidelines have been constructed in the absence of solid empirical evidence (Schneider et al., 2013). As a result, what exactly constitutes optimal management of a concussion remains unclear, including whether rest is the best approach, or whether active rehabilitation may provide greater therapeutic benefit.

This article is protected by copyright. All rights reserved.

Authors:   Bridgette D. Semple
Journal:   European Journal of Neuroscience
Year:   2016
Pages:   n/a
DOI:   10.1111/ejn.13346
Publication date:   12-Aug-2016
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