Effect of Early Rest on Recovery From Pediatric Concussion
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
Wisconsin
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Milwaukee, Wisconsin, United States, 53045
- Children's Hospital of Wisconsin
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- 11-22 years
- present to the Emergency Department within 24 hours of a head injury
Exclusion Criteria:
- patients who are being admitted,
- non-English speaking patient/family,
- mental retardation (IQ < 70)
- Suspected intoxication
- restricted used of dominant hand or limited vision
- injury or conditions affecting balance assessment
- prior mental defect or disease (e.g., developmental delay, learning disability, or moderate to severe cerebral palsy)
- known intracranial injury (e.g., intracranial bleeding, cerebral contusion)
- patients for whom a legal guardian is not present or cannot be contacted.
- ED clinician preference
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
No Intervention: Standard of Care
In this group, the treating attending physician will be free to make rest recommendations as they see fit.
An internal survey of physician practice found that the vast majority of physicians instruct patients rest for 1-2 days, then to return to school and physical activity after the patient's symptoms have resolved.
The amount of rest will vary from patients to patient based on variation in symptom resolution and patient compliance.
This advice is consistent with best practices outlined by the CDC.
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|
|
Experimental: Intervention
Mandated Rest.
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In addition to CDC based discharge instructions, the intervention group will receive instructions with strict activity restriction explicitly stating "No return to school" and "No Physical Activity" for the next five days.
Patients and parents in the intervention group will be provided school and work excuses for the five days post-injury.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Neurocognitive Outcomes
Time Frame: 10 days post injury
|
Neurocogntive outcomes assessed using computer-based neurocogntive testing based on changes from scores obtained in the emergency department to scores obtained at 3 days and 10 days.
|
10 days post injury
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Ancillary Neurocogntive Test Battery
Time Frame: 10 days
|
Assess neurocognitive outcome using a battery of neuro psych tests at 3 days and 10 days
|
10 days
|
|
Parental Attitude to Concussion:
Time Frame: 10 days
|
Assess potential barriers to compliance, we will assess parental attitudes toward concussion by administering a survey to parents or caregivers during the ten day home visit.
|
10 days
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Danny G Thomas, MD, MPH, Medical College of Wisconsin
Publications and helpful links
General Publications
- Sufrinko AM, Kontos AP, Apps JN, McCrea M, Hickey RW, Collins MW, Thomas DG. The Effectiveness of Prescribed Rest Depends on Initial Presentation After Concussion. J Pediatr. 2017 Jun;185:167-172. doi: 10.1016/j.jpeds.2017.02.072. Epub 2017 Mar 29.
- Silverberg ND, Iverson GL, McCrea M, Apps JN, Hammeke TA, Thomas DG. Activity-Related Symptom Exacerbations After Pediatric Concussion. JAMA Pediatr. 2016 Oct 1;170(10):946-953. doi: 10.1001/jamapediatrics.2016.1187.
- Thomas DG, Apps JN, Hoffmann RG, McCrea M, Hammeke T. Benefits of strict rest after acute concussion: a randomized controlled trial. Pediatrics. 2015 Feb;135(2):213-23. doi: 10.1542/peds.2014-0966. Epub 2015 Jan 5.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 5520163IRC
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