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Get kids back to school sooner after concussion for a better recovery, new study says

A new Canadian study says that kids who have suffered a concussion should get back to school sooner to give them a better recovery.
Angela Pike watches her fourth grade students at Lakewood Elementary School in Cecilia, Ky., as they use their laptops to participate in an emotional check-in at the start of the school day, Thursday, Aug. 11, 2022. The rural Kentucky school is one of thousands across the country using the technology to screen students’ state of mind and alert teachers to anyone struggling. (AP Photo/Timothy D. Easley)

A new Canadian study says that kids who have suffered a concussion should get back to school sooner to give them a better recovery.

The study, published in the JAMA Network Open on Friday, found that kids between eight and 18 who returned to school in fewer than three days after injury showed more improvement in symptoms 14 days later than kids who stayed home from school longer.

Senior author Dr. Roger Zemek, a concussion expert at the CHEO Research Institute in Ottawa, says concussion symptoms can include physical pain or dizziness, cognitive challenges, sleep disruption and emotional distress that affects mental health.

He says it’s OK for kids to still have some symptoms when they go back to class, as long as they can tolerate them.

Zemek says an early return to school allows kids to see their friends, avoid the stress of missing too many classes, keeping a normal sleeping schedule and doing light to moderate activity, which has previously been shown to be beneficial for blood flow and brain healing.

The study says it’s important for schools to make accommodations for students with concussions, such as excusing them from any contact-based gym activities where they could hit their head again and allowing students experiencing cognitive symptoms to postpone tests until they have improved.

Zemek suggests that concussion-injured students can start their early return by going to school for one or two hours first, then progressing to half days and then full days.

The researchers examined data for 1,630 children aged five to 18 who had been to nine emergency departments across Canada between August 2013 and June 2015. Just over half of the kids had missed only one to two days of school, which was considered an early return.

They found that decreased symptoms after 14 days were associated with an early return to school among kids age eight to 18 — even when their initial symptoms had been more severe. The researchers did not find the same association among the younger five- to seven-year-olds, but Zemek believes that’s because the youngest children recover better than their older counterparts regardless of when they go back to school.

Dr. Mark Halstead, a pediatric sports medicine physician at St. Louis Children’s Hospital who was not involved in the study, says the research findings “mirror what we see in clinic.”

“The nice thing (about) this study, which was well done and I feel the methodology was sound, is that it offers additional support that we don’t need to be isolating and shutting kids down completely from things to get them well, and in fact that may prolong recovery,” Halstead said in an email to The Canadian Press.

“We shouldn’t be afraid that making the brain work and doing some work in school — with proper breaks and adjustments to workload throughout the school day — will actually worsen the brain injury. It may worsen symptoms, but won’t injure the brain further,” he said.