New Guidance on mTBI Suggests Quicker Return to Low-Risk Activities, More Caution for Others

Many patients diagnosed with mild traumatic brain injury would benefit from getting back to their normal activities sooner than has been advised previously, according to a new review article published in the Journal of the American Medical Association. Introducing noncontact, aerobic exercise can even help improve symptoms and shorten time to recovery. However, other patients—those whose “normal activities” could put them at risk for repeat mTBI or who have persistent symptoms—should slow down even further than they might have been directed in years past. “More caution is needed regarding return to activities with a relatively high risk of head injury, such as sports, law enforcement, and military service,” the authors write. The same goes for any activity with increased opportunity for physical contact, in order to lower risk for overlapping mTBI. mTBI is associated with increased symptom severity, prolonged presence of symptoms, and (more rarely) rapid brain swelling and herniation. The bottom line is, the best way to inform return-to-activities decisions is to monitor an individual patient’s symptoms and advise accordingly. For a more specifically urgent care perspective, read Concussion Management in Urgent Care: A Primer for Implementation.