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The following is a summary of “Impact of Early Activity and Behavioral Management on Acute Concussion Recovery: A Randomized Controlled Trial,” published in the April 2025 issue of Journal of Pediatrics by Thomas et al. 

Early activity and behavioral management are commonly recommended for concussion recovery, but their effectiveness compared to standard care is unclear. 

Researchers conducted a retrospective study to assess the efficacy of early physical activity and behavioral management for acute concussion in pediatric patients. 

They conducted a multicenter, prospective, 2×2 factorial randomized controlled trial among patients aged 11-24 years who presented within 72 hours of injury. Participants were randomized into 4 groups based on early physical activity (or usual care) and behavioral management (or none). The early activity group was encouraged to meet step targets despite symptoms and primary outcomes were post-concussion symptom severity and quality of life at 14 days post-enrollment. 

The results showed that 239 participants were randomized, with 210 completing all study procedures. The early activity group had higher daily step counts than the usual care group. However, no significant differences were observed in post-concussion symptom severity or quality of life at 14 days between groups. The early activity group experienced higher symptom severity during the first 7 days and took longer to recover. Behavioral management showed no effect on outcomes. 

Investigators found that early prescribed physical activity and behavioral management did not improve post-concussion outcomes in the first 2 weeks. Early prescribed activity despite symptoms was associated with delayed symptom resolution. 

Source: jpeds.com/article/S0022-3476(25)00136-2/abstract