Longer period of rest needed?
Moser also questioned the authors' of the AAP clinical report's admittedly arbitrary recommendation that parent consider returning a concussed child back to learning when they are able to "tolerate symptoms comfortably for up to 30 to 45 minutes," as she was unsure what the phrase 'tolerate comfortably' meant.
"If a student, during the first week or more [after concussion], has headaches after being on a computer or reading for 30-40 minutes, then I am not sure how they can sustain a day of school, even with rest breaks between classes. I recommend that parents and students work with a concussion specialist who can tailor a plan for them and decide if the student really completed a long enough comprehensive rest period."
In the same vein, Moser questioned the AAP report's repeated assertion, based on research published in 2006,[6] that almost all pediatric athletes recover from concussion within three weeks, when more recent research using advanced neuroimaging and neuroradiologic techniques, as well as other research, has furnished "increasing evidence to suggest that the youth brain takes much longer to return to normal, likely months."
"Although the authors stress that each concussion is unique and there is no 'cookie-cutter' approach in management," Moser said she was "concerned that parents and health care providers will hinge their expectations [about recovery] on this 'three weeks' idea."
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3. Rocky Mountain Youth Sports Medicine Institute, Center for Concussion. REAP Guidelines. Available at: http://www.rockymountainhospitalforchildren.com/sports-medicine/concussi.... (accessed June 18, 2013)
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14.Harmon KG, Drezner J, Gammons M, et al. American Medical Society for Sports Medicine position statement: concussion in sport. Br J Sports Med. 2013;47:15-26.
