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Managing a concussion
Study of preteens, teens shows returning to normal routines more quickly is proving to be beneficial


May 2015

Kamren Pfeiffer returned to playing basketball sooner than he expected after suffering a concussion.

Advances in medical technology can present a vast array of treatment options and sometimes-miraculous outcomes. But there’s one area of health care that still challenges doctors because their patients won’t give them a straight answer.

Dr. Kevin Walter, program director of pediatric and adolescent sports medicine at Children’s Hospital of Wisconsin, says approximately one-third of the kids who suffer sports-related head injuries will lie about their condition, fearing that a concussion diagnosis could sideline them for months on end.

"Kids will think, ‘if I lie and sneak around, maybe I’ll get through this quicker,’" Walter says. "Athletes don’t want to say they’re hurt. And all of them know a concussion means you’re out."

But a new study by CHW and the Medical College of Wisconsin shows that accelerated re-acclamation to normal life, stimulating the brain sooner in the recovery process, can lead to quicker and better recoveries for young people diagnosed with concussions.

Dr. Danny Thomas, assistant professor in the department of pediatrics and emergency medicine at MCW, conducted the study, which took a more aggressive approach than the traditional "do nothing, strict rest" regimen of the past. "It really showed that it doesn’t help to shutter them away," Thomas says. "If anything, it aggravated their symptoms."

The study, which was published in The New York Times, concentrated on 99 kids between the ages of 11 and 18 within 24 hours of being diagnosed with a concussion. Within one to two days, the students resumed school attendance, starting with half-days and gradually taking steps to return to their normal routines. This approach proved more beneficial than the widely accepted standard of five days of total rest.

"Dr. Thomas’ paper validates everything we do in our concussion clinic," Walter says. "Sitting alone in a dark room doing nothing is not effective. You think about how bad life is and how bad you feel."

In February, 18-year-old Kamren Pfeiffer, a senior on the Brookfield Central High School basketball team, took a charge in the lane and landed on his head. Walter diagnosed him with a concussion. Pfeiffer stayed home for two days, then went half-days to school, and finally to full days in class followed by light exercise on a stationary bike. He returned to practice, started with stationary shooting drills, and was back on the court for the last four games of his high school career.

"That was really important," said Pfeiffer, who also suffered a basketball-related concussion during his sophomore year — a time when recovery "seemed a lot longer."

Pfeiffer, now considering a career in sports medicine or athletic training after this experience, thinks promptly resuming a normal routine helped him heal more quickly. "It helped my brain just trying to think of what I was just doing before I got injured," he says.

Thomas says treatment advice for each patient can still vary and that some kids can benefit from more rest. He’s received "a lot of positive feedback from the athletic community while getting some pushback from moms who are a little more cautious."

Thomas is currently working on funding for a new study with more patients hoping to further advance treatment of concussions. "If you’re a high school student and have an appropriately managed concussion, you’re not going to have brain injuries for the rest of your life," Thomas says. "The key thing is honing down on that management and figuring out the best way to do it."


This story ran in the May 2015 issue of: