Returning to school within two days of a concussion can lead to faster recovery in children and youth, according to a new Canadian study. The findings run contrary to a popular belief that time off school is best following a concussion, which is a type of traumatic brain injury.
"As a pediatric emergency physician who treats hundreds of youths with new and persistent concussion symptoms, I see far too many kids who are told to avoid school until they are symptom-free which can cause more harm and delay the recovery process," the study's senior author, Dr. Roger Zemek, said in a news release. "The results of this study provide strong evidence that an early return to school is associated with better outcomes."
Zemek is a senior scientist at the Children's Hospital of Eastern Ontario (CHEO) Research Institute in Ottawa, and the clinical research chair in pediatric concussion at the University of Ottawa. Published Friday in the peer-reviewed medical journal JAMA Network Open, part of the Journal of the American Medical Association, the study examined 1,630 youth aged five to 18 from nine Canadian pediatric emergency departments.
Although many medical groups recommend taking a day or two off school following a concussion, the study found that youth aged eight to 18 who returned to school within two days of a concussion were more likely to experience lower symptom burden and faster recoveries at two weeks, when compared with those who stayed at home longer. While the most symptomatic patients actually saw the greatest benefits, the same results were not observed in children aged five to seven.
"This study shows that children should make every effort to return to school even if they are still experiencing symptoms as it will help with their recovery process," explained Zemek, who also leads the Living Guideline for Pediatric Concussion Care, which provides up-to-date clinical recommendations and tools for managing youth with concussions.
The Canadian Paediatric Society (CPS) says that following a concussion, children "may have to initially stay home from school, as schoolwork can make symptoms worse."
"But, with support from the school, it is recommended that they go back as soon as they are able," the national group adds in its current concussion recommendations. "It is not necessary to wait until symptoms are entirely gone before returning."
The new study suggests that an early return to school may provide therapeutic benefits through socialization, reduced stress from not missing classes, maintaining a normal sleep-wake schedule, and returning to light-to-moderate physical activity. The study adds that a future clinical trial will be required to determine the best timing for returning to school following a concussion.
"In this cohort study of youth aged 5 to 18 years, these results supported the growing belief that prolonged absences from school and other life activities after a concussion may be detrimental to recovery," the study states. "An early return to school may be associated with a lower symptom burden and, ultimately, faster recovery."