Objectives:

This study aimed to analyze changes in physical activity (PA) recommendations after pediatric concussions and examine the associations of patient and injury characteristics with physicians' PA recommendations.

Design:

Retrospective observational study.

Setting:

Concussion clinics associated with a pediatric hospital.

Patients:

Patients aged 10 to 18 years with a concussion diagnosis, presenting to the concussion clinic within 14 days of the injury were included. A total of 4727 pediatric concussions and corresponding 4727 discharge instructions were analyzed.

Independent Variables:

The independent variables for our study were time, injury characteristics (eg, mechanism and symptom scores), and patient characteristics (eg, demographics and comorbidities).

Main Outcome Measures:

Physician PA recommendations.

Results:

From 2012 to 2019, the proportion of physicians recommending light activity at an initial visit increased from 11.1% to 52.6%(P< 0.05) within 1-week postinjury and from 16.9% to 64.0% during the second week postinjury (P< 0.05). A significantly increased odds of recommending “light activity”(odds ratio [OR]= 1.82, 95% confidence interval [CI], 1.39-2.40) and “noncontact PA”(OR= 2.21, 95% CI, 1.28-2.05), compared with “no activity” within 1-week postinjury, was observed in each consecutive year. In addition, higher symptom scores at the initial visit were associated with lower likelihood of recommending “light activity” or “noncontact PA.”

Conclusions:

Physician recommendation of early, symptom-limited PA after a pediatric concussion has increased since 2012, which mirrors a shift in acute concussion management. Further research assessing how these PA recommendations may facilitate pediatric concussion recovery is warranted.