Advice to Rest for More Than 2 Days After Mild Traumatic Brain Injury Is Associated With Delayed Return to Productivity: A Case-Control Study

Conclusions: mTBI patients continue to be told to rest for longer than expert recommendations and practice guidelines. This study supports growing evidence that prolonged rest after mTBI is generally unhelpful, as patients in the exposure group were less likely to have resumed work/school at 1–2 months post-injury. We could not identify patient characteristics associated with getting prolonged rest advice. Further exploration of who gets told to rest and who delivers the advice could inform strategic de-implementation of this clinical practice. Introduction In the early twenty-first century, complete rest until symptom resolution was introduced as best practice for mild traumatic brain injury (mTBI) management (1, 2). This practice was widely disseminated (3, 4) and followed (5, 6). Despite a lack of evidence for efficacy or agreement about what constitutes “rest,” the majority of observational studies (7–10) and randomized clinical trials (11–13) have found that rest beyond few days after mTBI is not beneficial, and may actually prolong recovery (14). Concerns have also been raised about iatrogenic physiological and psychological effects of prescribed rest. For example, removing individuals from their recreational, occupational, and social settings may increase their risk of developing depression (15–17). Correspondingly, the most recent expert consensus statements and practice guidelines for both sport-related mTBI and m...
Source: Frontiers in Neurology - Category: Neurology Source Type: research