From these headlines, it appears that a study published in the journal Pediatrics on Monday found that it is harmful for adolescents to rest their bodies and minds for five days following a concussion:

• “Too Much Rest Is Harmful After a Concussion, Study Finds” (U.S. News & World Report)
• “For Kids With Concussions, a Couple Days' Rest Is Enough” (Bloomberg)
• “Kids With Concussions: Recovery in Just Two Days” (Chicago Daily Herald)
• “For Kids With Concussions, Recovery Requires Just Two Days’s Rest” (Chicago Tribube)
• “Short Rest OK After Adolescent Concussion” (Columbus Dispatch)

None of them adequately sum up the findings of the study, which included 88 adolescents with mild traumatic brain injuries (concussions). Of those, 45 were told to refrain from physical and mental activity for five days. The other 43 were told to rest for one to two days, then slowly increase their level of activity, as the current recommendations for concussion care advise. The study found that:

• Patients in the two groups reported similar levels of physical activity following the concussion. Both had about a 20% decrease in physical activity.
• Those who were told to rest for five days missed more school, as was to be expected.
• Ultimately, there were no differences between the two groups in their ability to think clearly, balance, or physical symptoms.
• Those who rested for five days reported more symptoms in the 10 days following the injury than those who were able to return to school after two days. Right after the concussion, these symptoms were physical; as the days of rest wore on, the increased symptoms were emotional.
• Discharge instructions, which include amount of rest, could influence a patient's perception of illness, according to study co-author Dr. Danny G. Thomas.

Researchers posit that those in the group told to rest for five days experienced emotional distress caused by not seeing friends and falling behind in schoolwork. That distress may have increased their physical and emotional symptoms. In addition, the restrictions and ensuing lack of exercise could disrupt sleep and cause mood disruptions. The group that returned to school after a day or two of rest may have been distracted from the symptoms or caused them to give less time and attention to recording their symptoms, which was required for the study.

The study found that extra mental rest wasn’t better than shorter rest and that those who rested longer had more short-term complaints than those who returned to school after a day or two. It did not conclude that resting for a longer period caused long-term harm, nor did it find that returning to full physical and mental activity only one or two days after a concussion is safe or advantageous.

The headlines may have grabbed attention, but the findings of this study aren't flashy. More rest isn't necessarily better. Patients should rest for a day or two following a concussion, then see their primary care physician or a sports medicine physician to determine the best plan for returning to activity, the study's authors advise. Concussion recovery is highly individual and should be customized to each patient.

References

Benefits of Strict Rest After Acute Concussion: A Randomized Controlled Trial, Pediatrics, doi: 10.1542/peds.2014-0966, published online January 5 2014.

Reuters Health, Study Questions Value of Prolonged Rest After Acute Concussion, published online January 5 2014. Accessed 6 January 2015.

Medical News Today, Is Prolonged Rest the Best Medicine for Concussion?, published online January 6 2014. Accessed 6 January 2015.