“After a concussion, active rehabilitation is necessary to allow for a normal recovery for many people.”
Leddy et al. Active rehabilitation of concussion and post-concussion syndrome. Phys Med Rehabil Clin N Am. 2018
Is Rest the Best Recovery Method?
Rest has long been considered “the best medicine” for concussions. However, there have been documented problems with rest as an approach to concussion management. When critically analyzed, the benefits of rest are largely assumed rather than evidence-based. In fact, being sedentary after an injury or illness is one of the most consistent risk factors for chronic disability. Inactivity can precipitate, exacerbate, and/or prolong recovery from many health conditions, including those most often comorbid with concussion such as dizziness, depression, post-traumatic stress disorder, chronic fatigue, and pain disorders.
When Should Active Recovery Take Place?
Repeat concussion is most likely to occur within days of the initial injury and there is evidence that the brain may be especially vulnerable to a second injury if it occurs before recovery from the initial concussion. Premature voluntary exercise within the first week after concussion impairs recovery, while aerobic exercise performed 14 to 21 days after concussion improves cognitive performance. Therefore, it is strongly recommended for patients to rest for the first 10 to 14 days. After this time period it is recommended to withhold patients from activities with heightened head trauma exposure risk (eg, athletes returning to contact sports and military service personnel returning to combat), but not physical activity, exercise, or cognitive exertion.
Who Benefits Most From Active Rehab and Why?
Patients who have persistent signs and symptoms four weeks after head injury benefit from active rehabilitation. Exercise influences multiple neurotransmitter systems and promotes new brain cells, new blood cells in the brain, and new brain connections. There is evidence that appropriate rehabilitation can activate the affected neural circuitry and can facilitate reorganization and functional recovery from concussion. The goal of the rehabilitation is to create a specific rehabilitation environment for each individual patient which forces their nervous system to improve their functional limitations in conjunction with many musculoskeletal therapies.
For more information about The Neurologic Wellness Institute and our Concussion Rehabilitation Program contact us at: info@neurowellnessinstitute.com
