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Introduction: Novel research suggests that children engaging in physical activity during recovery from concussion may recover more rapidly. Objective: To determine if level of physical activity at presentation to a rehabilitation‐based concussion specialty clinic predicted days from injury to recovery. Design Retrospective cohort. Setting: A concussion sub‐specialty clinic at an academic institution. Patients Retrospective review of medical records between September 2015 and February 2017 identified 178 children ages 6‐17 years (mean age = 13.7 years; standard deviation [SD] = 2.7 years) who presented within 60 days of concussion and were ultimately deemed recovered and cleared to progress to full return to high‐risk activities. Interventions: Not applicable. Main Outcome Measures: Physical activity at initial visit was classified as none‐to‐light (79%) versus moderate‐to‐heavy (21%). A doubly robust, inverse probability of exposure weighted linear regression model was used to examine the relationship between physical activity level and days to recovery, while adjusting for 10 demographic and clinical variables. Results: Children participating in moderate‐to‐heavy activity at initial evaluation in concussion clinic averaged recovery 21 days quicker (95% confidence interval [CI] −27.1, −15.5, P <.001) than children who were engaging in none‐to‐light activity. This finding did not change when removing children who were deemed recovered at the first visit (who may have initiated physical activity after becoming asymptomatic). Conclusions: These data add to growing evidence that progressive physical activity during recovery from concussion does not appear to be harmful. Physical activity represents a modifiable variable in recovery, and physicians can potentially expedite symptomatic recovery by recommending noncontact physical activity as tolerated during concussion recovery. [ABSTRACT FROM AUTHOR]

Background: Current concussion evidence is derived largely from teenagers and adults. Concussion in younger children occurs within the context of neuromaturation, with differing age-based pathophysiological responses to injury. Therefore, our current understanding of concussion in older children and adults is unlikely to directly apply to younger children.Objective: To describe patient variables, clinical course, and factors associated with time to discharge from concussion care in children 6-12 years of age with concussion treated in an interdisciplinary rehabilitation-based concussion clinic.Design: Retrospective chart review.Setting: Interdisciplinary concussion clinic at an academically affiliated rehabilitation center.Patients: Children aged 6-12 years (n = 105; mean 10.8 years of age, 70% male) seen within 60 days of concussive injury.Main Outcome Measurements: Descriptive statistics explored demographic, injury, and clinical features. The primary outcome measure, time to discharge from concussion care, was estimated with survival-analysis methods based on the date of discharge from the clinic. Multivariate models were used to examine factors associated with longer time to discharge.Results: Median time to discharge was 34 days postinjury (range 5-192 days); 75% of children were discharged within 60 days of injury. A minority reported persisting symptoms at discharge. Younger age and increased symptom burden at initial evaluation predicted longer time to discharge.Conclusions: Although children 6-12 years old treated in a specialty concussion clinic show variability in time to discharge from concussion care, most were discharged within 2 months after injury. Risk factors for prolonged recovery, such as younger age and greater symptom burden at initial visit, can be used when counseling families and planning interventions. There may be varying contributions, including psychosocial stressors, to ongoing symptoms in children who experience persisting symptoms after other concussion-related concerns have resolved. Future work focused on the subset of children who report persisting symptoms will be useful for developing an evidence base related to their care.Level Of Evidence: II. [ABSTRACT FROM AUTHOR]