Evaluation of an active rehabilitation program for concussion management in children and adolescents.

OBJECTIVE: To estimate the extent to which post-concussion symptoms were influenced by participation in an Active Rehabilitation (AR) program (aerobic exercise, coordination drills, visualization and education) for children and adolescents who are slow to recover from concussion. A secondary exploratory objective included examining the influence of sex on symptom evolution.

METHODS: Analysis of prospectively collected data was performed on 277 youth who initiated an AR program, between three and four weeks post-injury at a Concussion Clinic in a tertiary care paediatric teaching hospital.

MAIN OUTCOME MEASURE: Post-concussion symptom scale (PCSS) from Sport Concussion Assessment Tool-3 (SCAT 3).

RESULTS: Children and adolescents participating in an active rehabilitation program displayed improved post-concussion symptom severity at follow-up (median = 9.5) compared to pre-intervention (median = 18) (p < .05). Patients demonstrated improved physical, cognitive, emotional and sleep-related post-concussion symptoms (p < .05). Female sex was associated with an increased post-concussion symptom severity at follow-up.

CONCLUSIONS: Youth experiencing persisting symptoms three to four weeks post-concussion demonstrated improved post-concussion symptoms scores (physical, cognitive, emotional and sleep related) with participation in an active rehabilitation program.