1. Is early activity resumption after paediatric concussion safe and does it reduce symptom burden at 2 weeks post injury? The Pediatric Concussion Assessment of Rest and Exertion (PedCARE) multicentre randomised clinical trial
- Author
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Andrée-Anne Ledoux, Mark S. Tremblay, Roger Zemek, Michael M. Borghese, Joel D. Barnes, Sarah Reid, Candice McGahern, Nick Barrowman, Adrienne L. Davis, Ken J. Farion, Carol DeMatteo, Vid Bijelic, Keith Owen Yeates, Gurinder Sangha, Nicholas S. Reed, and Kevin Belanger more...
- Subjects
Male ,Canada ,medicine.medical_specialty ,Adolescent ,Rest ,Physical Exertion ,Physical Therapy, Sports Therapy and Rehabilitation ,Asymptomatic ,Post injury ,law.invention ,Randomized controlled trial ,law ,Internal medicine ,Concussion ,Humans ,Medicine ,Orthopedics and Sports Medicine ,Exertion ,Child ,Adverse effect ,Brain Concussion ,Rest (music) ,Post-Concussion Syndrome ,business.industry ,General Medicine ,medicine.disease ,Clinical trial ,Female ,medicine.symptom ,business - Abstract
ObjectiveInvestigate whether resuming physical activity (PA) at 72 hours post concussion is safe and reduces symptoms at 2 weeks, compared with resting until asymptomatic.MethodsReal-life conditions, multicentre, single-blinded randomised clinical trial, conducted in three Canadian paediatric emergency departments (ED). Children/youth aged 10–Results456 randomised participants (EG: N=227; mean (SD) age=13.3 (2.1) years; 44.5% women; CG: N=229; mean (SD) age=13.3 (2.2) years; 43.7% women) were analysed. No AE were identified. ITT analysis showed no strong evidence of a group difference at 2 weeks (adjusted mean difference=−1.3 (95% CI:−3.6 to 1.1)). In adherent participants, initiating PA 72 hours post injury significantly reduced symptoms 2 weeks post injury, compared with rest (adjusted mean difference=−4.3 (95% CI:−8.4 to –0.2)).ConclusionSymptoms at 2 weeks did not differ significantly between children/youth randomised to initiate PA 72 hours post injury versus resting until asymptomatic; however, many were non-adherent to the intervention. Among adherent participants, early PA was associated with reduced symptoms at 2 weeks. Resumption of PA is safe and may be associated with milder symptoms at 2 weeks.Level of evidence1b.Trial registration numberNCT02893969.Registry namePediatric Concussion Assessment of Rest and Exertion (PedCARE). more...
- Published
- 2021
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