Strict rest for children who have suffered concussions could do more harm than good, according to a growing body of research. It can lead to them being ‘cocooned’ – a lack of stimulation and activity that may be bad for the developing brain. Avoiding contact sports is still key, but a leading neurosurgeon says previously-banned activities like homework, swimming and video games could speed recovery from concussions. After a few days rest, Neurosurgeon Dr Christopher Giza says the brain needs exercise to avoid problems like depression, poor sleep and anxiety. Soon, recovering children should get back to some cognitive activities such as reading, homework or playing video games – and non-risky exercise like walking and swimming.
The theory behind complete brain rest is that by avoiding any mentally taxing activities, the brain has a chance to conserve energy as normal blood flow is restored to injured areas. Prolonged absences from school, anxiety, depression, de-conditioning, sleep disturbances and other problems were increasingly seen as challenges in the recovery from concussion. But recent research on animal models has shown voluntary exercise at the appropriate boosted recovery and cognition – sometimes even very early after injury – may be safe and lead to faster healing.
Basic neuroscience has shown mental activity is essential for brain development – strengthening communication and connections between neurons and increasing grey matter. Dr Giza asked, then: ‘So why would complete brain rest be good for a developing brain?’ Controlled exercise is now newly-included as a consideration in recommendations for the management of sport-related concussion.