UPFRONT | Roundup PATIENT CARE Light exercise post-concussion may halt prolonged symptoms: study Getting physical exercise within a week of suffering a concussion may reduce a young person’s risk of expe-riencing ongoing symptoms, say researchers, whose find-ing runs counter to conven-tional guidelines calling for strict mental and physical rest following the common brain injury. “Exercise is probably a good medicine,” said Dr. Roger Zemek of the Chil-dren’s Hospital of Eastern Ontario, who led the study of Canadian children and teens conducted at nine pediatric hospitals across the country. Those who said they re-sumed light to moderate ac-tivity soon after a concussion – such as walking, swimming and stationary cycling – were found to be less likely to have such symptoms as nausea, headaches and dizziness a month later. Exercise increases blood flow to the brain and could help speed up healing and improve cognitive function, which is often altered as the result of a concussion, re-searchers said. “We also know that by getting outside and doing this, patients are taken away from that negative cycle of ‘I’m sick’ and being stuck in that sick role,” Zemek said from Ottawa. “And perhaps they’re seeing something they can do to help them improve.” To conduct the study, pub-lished in the Journal of the American Medical Association, researchers surveyed almost 2,400 kids ranging in age from five up to 18 who were treated for concussion in hospital emergenc y Youth mental health agencies need more oversight: report Despite a 50 per cent increase in hospitalization of children and youth with mental-health prob-lems since 2008/09, the province of Ontario has not analyzed the reasons for the increase or taken steps to address it, the province’s Auditor General Bonnie Lysyk said in her 2016 Annual Report. One in five Ontarians will expe-rience a mental-health problem in their lifetime, and most problems begin in childhood or adolescence. “It is crucial that the govern-ment do its best to understand the reasons for these troubling statis-tics and that it can provide timely and appropriate treatment and avoid the potential high social and financial cost of not dealing proac-tively with the issue,” Lysyk said. The Ministry of Children and Youth Services provided $438 million to more than 400 child and youth mental health service providers in 2015/16 to fund services to 120,000 registered clients. The auditor general found that despite the 50 per cent increase in hospitalization of children and youth with mental-health prob-lems, the ministry has not worked with other ministries involved in the government’s Comprehensive Mental Health and Addictions Strategy to analyze the reasons for the increase, and to address it. The report also found the min-istry does not monitor the perfor-mance of the Child and Youth Mental Health Program and agen-cies to ensure they are providing cost-effective mental-health ser-vices. www.canadianchiropractor.ca MENTAL HEALTH departments. About 70 per cent of the brain injuries oc-curred while playing sports or doing other recreational activities. Patients and their parents were asked about symptoms and physical activity at seven and 28 days after the concus-sion. In the early-exercise group, 29 per cent reported ongoing or worsening symp-toms 28 days after their concussion, compared with 43 per cent of those who avoided physical activity. Among children and teens who reported having three or more symptoms that first week, those who engaged in early physical activity were 25 per cent less likely to have ongoing or worsening prob-lems at one month – “regard-less of the intensity” – com-pared to those who chose rest over exercise, Zemek said. He believes the findings suggest guidelines mandating strict rest until concussion symptoms disappear need to be reconsidered – with one caveat. “I do feel we need to be prudent and really make sure this is not taken as a free pass to go back to competition ... (not) until they’re medically cleared.” Dr. Paul Echlin, a Burling-ton, Ont., sports medicine physician who treats young athletes with brain trauma, said getting a patient active at a low level without exacer-bating their injury makes sense. Echlin, who was not in-volved in the research, said he encourages his concussion patients to be as active as symptoms allow. “If you don’t isolate or don’t immobilize somebody, then you’re going to have a better result.” While the premise of this study is reasonable, it doesn’t show how complex concus-sions can be, he said. “Rest and activity are both important in the essential recovery of a person with traumatic brain injury, but so are the diagnosis of all the other components – and not to centre it around just one or the other, but to say (phys-ical activity) is one of the many things that will help a person recover.” -Sheryl Ubelacker, The Canadian Press 10 Canadian Chiropractor February 2017
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