Jérôme Gauvin-Lepage1,2, Debbie Friedman3,4,5,6,7, Lisa Grilli8, Maria Sufrategui8, Carol De Matteo9,10, Grant L Iverson11,12,13,14, Isabelle Gagnon15,16. 1. Faculty of Nursing, University of Montreal, Montreal, QC, Canada. 2. Research Center of the Sainte-Justine University Hospital, Montreal, QC, Canada. 3. The Montreal Children's Hospital Trauma Centre, McGill University Health Centre, Montreal, QC, Canada. 4. Canadian Hospitals Injury Reporting and Prevention Program, Health Canada, Montreal, QC, Canada. 5. Departments of Pediatrics; and. 6. Pediatric Surgery, Faculty of Medicine, McGill University, Montreal, QC, Canada. 7. Student Affairs, Faculty of Medicine, McGill University, Montreal, QC, Canada. 8. MTBI Program and Concussion Clinic, The Montreal Children's Hospital Trauma Centre, McGill University Health Centre, Montreal, QC, Canada. 9. School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada. 10. CanChild Centre for Childhood Disability Research, Hamilton, ON, Canada. 11. Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts. 12. Spaulding Rehabilitation Hospital, Charlestown, Massachusetts. 13. MassGeneral Hospital for Children Sports Concussion Program, Boston, Massachusetts. 14. Red Sox Foundation and Massachusetts General Hospital Home Base Program, Boston, Massachusetts. 15. School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC, Canada; and. 16. Kids and Teens Concussion Research Lab, The Montreal Children's Hospital Trauma Centre, McGill University Health Centre, Montreal, QC, Canada.
Abstract
OBJECTIVE: (1) To determine the impact of providing participants aged 8 to 17 years who are slow to recover after a concussion with a well-developed active rehabilitation intervention (ARI), compared with receiving standard care alone, on postconcussion symptoms (PCS) at 2 and 6 weeks after the initiation of ARI; and (2) to investigate functional recovery 6 weeks after initiation of ARI. DESIGN: A multicenter prospective quasi-experimental control group design. SETTING:Tertiary care pediatric trauma center and community health care providers. PARTICIPANTS: Forty-nine youth were enrolled (experimental n = 36; control n = 13). PROCEDURES: Participants were assessed on 3 different occasions: (1) initial visit (baseline); (2) 2 weeks; and (3) 6 weeks after enrollment. MAIN OUTCOME MEASURES: Child- and parent-reported PCS were obtained by the PCS Inventory Scale (primary outcome). Secondary outcomes included: (1) mood and anxiety; (2) quality of life; (3) energy level; (4) coordination and balance; (5) neurocognition; (6) parental anxiety; and (7) satisfaction with intervention. RESULTS: Both groups reported decrease of PCS over time (child: P = 0.01; parent: P = 0.03). Children in the experimental group presented higher quality of life (P = 0.04) and less anger (P = 0.02). A trend toward significance was observed for better tandem gait (P = 0.07) and for less general fatigue on self-reported PCS (P = 0.09) in the experimental group. CONCLUSIONS:Active rehabilitation intervention does not affect the PCS beyond the usual management, but it increases their quality of life, decreases anger, and potentially increases energy level and balance.
RCT Entities:
OBJECTIVE: (1) To determine the impact of providing participants aged 8 to 17 years who are slow to recover after a concussion with a well-developed active rehabilitation intervention (ARI), compared with receiving standard care alone, on postconcussion symptoms (PCS) at 2 and 6 weeks after the initiation of ARI; and (2) to investigate functional recovery 6 weeks after initiation of ARI. DESIGN: A multicenter prospective quasi-experimental control group design. SETTING: Tertiary care pediatric trauma center and community health care providers. PARTICIPANTS: Forty-nine youth were enrolled (experimental n = 36; control n = 13). PROCEDURES: Participants were assessed on 3 different occasions: (1) initial visit (baseline); (2) 2 weeks; and (3) 6 weeks after enrollment. MAIN OUTCOME MEASURES: Child- and parent-reported PCS were obtained by the PCS Inventory Scale (primary outcome). Secondary outcomes included: (1) mood and anxiety; (2) quality of life; (3) energy level; (4) coordination and balance; (5) neurocognition; (6) parental anxiety; and (7) satisfaction with intervention. RESULTS: Both groups reported decrease of PCS over time (child: P = 0.01; parent: P = 0.03). Children in the experimental group presented higher quality of life (P = 0.04) and less anger (P = 0.02). A trend toward significance was observed for better tandem gait (P = 0.07) and for less general fatigue on self-reported PCS (P = 0.09) in the experimental group. CONCLUSIONS: Active rehabilitation intervention does not affect the PCS beyond the usual management, but it increases their quality of life, decreases anger, and potentially increases energy level and balance.
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