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New rules for pediatricians say light exercise, phone use OK for children with concussions

Donato Maffin | U.S. Marine Corps

Children with concussions should be able to continue exercising and using electronics, according to new treatment guidelines from the American Academy of Pediatrics.

For years, doctors have recommended children who suffered a concussion stay in a dark room with few distractions with the belief it would speed up healing. The new guidance encourages pediatricians to recommend that children engage in moderate exercise and electronics use.

The change could help doctors and the patients nationwide, said Mark Halstead, a Washington University pediatrics professor and director of the sports concussion clinic at St. Louis Children’s Hospital. The American Association of Pediatrics estimates as many as 1.9 million children are treated for a sports-related concussion annually.

“Kind of trying to shut things down completely, especially for an athlete can be very frustrating after a while. So we’re trying to encourage earlier activity,” said Halstead, lead author of the report outlining the rules in the upcoming issue of the journal Pediatrics. “It doesn’t mean returning to their normal sports or returning to normal practices, but light cardiovascular activities.”

According to the Missouri State High School Activities Association,nearly 3,000 high school athletes suffered concussions in the 2017-2018 school year. Close to twice as many boys than girls had concussions. Football was by far the most frequent cause of the injuries; 1,185 people had football-related concussions. The next-worst sport for concussions was girls’ soccer, which tallied 337 concussions that school year.

When children are forced to sit in the dark, it can feel like they’re being punished for getting hurt, Halstead said.

“You can imagine how that would feel to you, if you were told to stay in the dark for days on end and not have any stimulus at all,” he said, “People would get kind of grumpy and feel kind of out of it.”

The Academy of Pediatrics never directly recommended that kids cease the use of electronics or other screen time, but doctors were quick to recommend it after earlier guidance said it too much stimulation could make children feel sick, Halstead said.

“Unfortunately, when you put out guidelines they take it to the extreme,” he said.

However, concussions can still make children sensitive to light and sound, he said. A doctor can recommend what’s best for each individual case.

More children are being treated for concussions in a doctor’s office than in the past, thanks to a 2011 Missouri law that requires high school students to obtain a doctor’s approval before participating in sports after a head injury, Halstead said.

Follow Sarah on Twitter: @petit_smudge

Sarah Fentem is the health reporter at St. Louis Public Radio.