Early, Multidisciplinary Care Boosts Concussion Recovery in Children
A new randomized clinical trial published in the British Journal of Sports Medicine finds that children receiving early, specialized care for persistent post-concussion symptoms recover at significantly higher rates than those receiving standard treatment.
At the three-month mark, 62.5% of children in the intervention group were fully recovered, compared to just 37% in the standard care group.
Conducted by researchers at the Murdoch Children's Research Institute (MCRI) at The Royal Children's Hospital in Melbourne, the study focused on the 30% of children who do not recover within the typical three-week window.
Study Design
The trial included 158 participants, aged 8 to 18, recruited from the hospital’s emergency department and general practitioner referrals. Treatment began four weeks after the initial injury. Participants were randomly assigned to either the "Concussion Essentials" intervention program or a control group receiving standard care.
The Intervention: Concussion Essentials
Developed by MCRI in partnership with the Neurological Rehabilitation Group, the program combines tailored education, physiotherapy, and psychological support. Treatment was delivered through weekly one-hour sessions for up to eight weeks, including specific guidance on returning to school and sport.
Key Findings at Three Months
- Recovery Rate: 62.5% of intervention children were fully recovered, versus 37% in the standard care group.
- Symptom Improvement: 94% of children in the intervention group showed improvement.
- Persistent Symptoms: Only 6% of the intervention group continued to experience symptoms. Researchers noted these cases were often linked to pre-existing mental health conditions, chronic migraines, or autonomic nervous system dysfunction.
Standard Care vs. New Approach
Researchers noted that current standard care often involves single treatments or referral delays. Current guidelines encourage gradual activity after 48 hours and a return to school within weeks. In Australia, a minimum 21-day pause from contact sport is standard.
Lead researcher Professor Vicki Anderson stated: "Parent anxiety can delay a child's recovery. Concussion is treatable if managed appropriately."
The Challenge of Concussion in Children
Concussion is common, with one in five children sustaining one by age 10.
- Diagnosis remains difficult, as no blood test or standard MRI can definitively distinguish concussion from normal brain function.
- Common symptoms include headache, dizziness, balance problems, and sensitivity to light or noise.
- Falls account for roughly half of concussion-related hospitalizations.
- Sport-related concussions account for about one in five, with cycling linked to the highest number of hospitalizations.
Practical Advice from Experts
Principal physiotherapist Katie Davies emphasized the importance of pacing activity: "Do a little bit, just can't do too much."
Availability and Future Plans
The Concussion Essentials program is also available as a mobile application called HeadCheck, developed by MCRI with the Australian Football League. MCRI has received funding to roll the program out nationally via telehealth. Similar services are already available at Royal North Shore Hospital in Sydney and Princess Alexandra Hospital in Brisbane. The study was supported by a grant from the Victorian Medical Research Acceleration Fund.