The Recommendation for Rest Following Acute Concussion

The acute management of concussion is an important area of investigation and an area of clinical importance to the pediatrician. Recent studies suggest that concussions account for more than 10% of all sport-related injuries sustained by high school athletes and reveal an increase in the number children with concussions being cared for in emergency departments.^1–3  At present, the mainstay of concussion management calls for both cognitive and physical rest until the acute symptoms resolve, followed by a graded return to activity.⁴  As noted by several medical societies, the evidence on which the recommendations for rest are based is sparse.^4–6  This relative lack of evidence is due, in part, to the difficult nature of quantifying and tracking levels of physical and, particularly, cognitive activity. In this issue of Pediatrics, Thomas et al⁷  take this challenge head on; they should be applauded for...