Kids Should Rest, Even Avoid Homework After Concussions

A new study shows that kids need to cut back on mental exertion, as well as physical exercise, when they’re recovering from a concussion — including avoiding homework.

According to a study published in Pediatrics on Monday, nearly 50% of the kids and young adults who didn’t reduce their mental strain after a concussion took 100 days or more to fully recover. Among those who cut back the most, almost all had recovered by 100 days, and most in a shorter period.

This is the first study to back that recommendation up with data despite specialists long suspecting that cutting back on mental activities would shorten recovery time. For children being treated, whose developing brains are particularly vulnerable to concussion damage, this study could be all important for them. As the study co-author Dr. William Meehan, director of the Sports Concussion Clinic at Boston Children’s Hospital states, it will be enough to cut back for three to five days for many kids.

“Then you can gradually reintroduce them to cognitive activity. They should do as much as they can without exacerbating their symptoms,” he said.

According to Linda Carroll of NBC News, Meehan and his colleagues followed 335 patients aged 8 to 23 at the sports concussion clinic at Boston Children’s Hospital for the new study. The patients, whose average age was 15, were asked at each visit to the concussion clinic about their symptoms and to describe how much they’d worked their brains since the last visit. The five possible responses ranged from complete cognitive rest to no cutback at all.

As David Hovda, a professor of neurosurgery and director of the Brain Injury Research Center at the University of California, Los Angeles put it, the new findings fall in line with animal research and imaging studies that have shown what happens during a concussion. He said that when the brain is jolted hard, it experiences a sort of mini-seizure.

“All the cells fire and the brain needs an enormous amount of fuel to equilibrate,” he explained. “The brain is then exhausted so it shuts down and becomes very quiet,” he said.

Additionally, he said that quiet is what the brain needs to repair itself.

“If you activate the brain during the time it’s trying to shut itself down, it will activate, but that will make recovery much more prolonged,” he said.

His words were echoed by Dr. Douglas Smith, a professor of neurosurgery and director of the Center for Brain Injury and Repair at the University of Pennsylvania Medical Center, who said that people need to realize that “it can take days to weeks for processes in the brain to mop up the mess from a concussion.”

According to Dr. Robert Cantu, a professor of neurology and neurosurgery at the Boston University School of Medicine and co-director of the Center for the Study of Chronic Traumatic Encephalopathy, just how much kids needs to reduce their mental activity will depend on the number and severity of symptoms.

“You do everything based on what doesn’t aggravate the situation,” Cantu said. “If kids can do 15 to 20 minutes on the computer without aggravating their symptoms, let them. But if headaches get worse after only 5 or 10 minutes, then you need to shut this down completely. Everything needs to be tailored to the individual.”

Symptoms can be worsened by the slightest mental exertion for some kids.

“There are definitely individuals with symptoms that are so bad that the best thing to do is to take a period of months off from school,” Cantu said. “That is a small minority, however.”