Exam 3 question 98 concussion

[James Wallace]

The latest evidence as provided by “Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016” states rest is not recommended post 48 hours.

Most consensus and agreement statements for managing SRC recommend that athletes rest until they become symptom-free. Accordingly, prescribed rest is one of the most widely used interventions in this population. The basis for recommending physical and cognitive rest is that rest may ease discomfort during the acute recovery period by mitigating post-concussion symptoms and/or that rest may promote recovery by minimising brain energy demands following concussion.

There is currently insufficient evidence that prescribing complete rest achieves these objectives. After a brief period of rest during the acute phase (24–48 hours) after injury, patients can be encouraged to become gradually and progressively more active while staying below their cognitive and physical symptom-exacerbation thresholds (ie, activity level should not bring on or worsen their symptoms). It is reasonable for athletes to avoid vigorous exertion while they are recovering. The exact amount and duration of rest is not yet well defined in the literature and requires further study.

Thanks for these exams. They have been very helpful!

[Chrissy Durrough Lugge]

Thanks for sharing, James! This supports what I see clinically – that most of my patients who are told to rest for weeks-months after sustaining a concussion before being referred to PT tend to have much more protracted recoveries than those to return to some level of activity sooner.

The ABPTS has a rigorous process for developing and vetting exam questions. As a result, there is a bit of a lag in content and much of the latest evidence is not directly tested. My advice is always to answer questions based on what you know…but don’t be surprised if there isn’t a ton of material from the last 2-3 years.

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