We already know that physical therapy can help adolescents who have concussion symptoms. Now, a new study suggests that starting physical therapy earlier provides similar outcomes to starting physical therapy later. This study, published in the July issue of The Journal of Neurologic Physical Therapy, shows that physical therapy interventions can be safely administered within the first three weeks following an injury.
How was the study performed?
The researchers looked at 120 adolescents with concussion-related symptoms. The patients were divided into three groups: those who received physical therapy early (0-20 days after concussion), in the middle (21-41 days), and late (42 days or later). The physical therapy treatment was multimodal and delivered by therapists who were trained to treat concussion patients. The exercises included cervical spine manual therapy, strengthening exercises, stretching, and training involving the inner ear and visual symptoms.
What was the result?
All three groups had similar results! It didn't matter whether the physical therapy began earlier or later. The researchers did find that some symptoms worsened, particularly in the late group. It's possible these patients suffered from symptoms like depression or sleep issues, which physical therapy does not directly treat.
What is the take-away from this study?
The recommendations for young patients with concussion symptoms used to be complete rest (both physical and mental) until the symptoms went away. However, this study and other recent research has found that resting more than one or two days does not have many benefits. Thus, there is a shift toward less rest and gradually returning to normal activity.
The take-away for physical therapists: physical therapy is safe for adolescents with concussion symptoms, even if the therapy begins early. Introducing physical therapy earlier adds the benefit of possibly lessening recovery time.
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