Grant: Operating Grant

The decision regarding return to activity following Mild Traumatic Brain Injury (MTBI)/concussion is one of the most difficult and controversial areas in concussion management for adults and even more complicated for children and youth. Children who sustain a concussion are being provided with management strategies that have been designed for adult athletes. Children and youth are at high risk for repeat injuries within a short period of time as well as prolonged symptoms affecting their school and leisure participation. Experts agree that return to activity (RTA) including return to school (RTS) decisions should be more conservative, cautious and individualized for children and youth. Our clinical and research team at McMaster Children's Hospital and CanChild have developed new RTA and RTS guidelines as part of a study to educate family doctors about concussion in children. The current grant will evaluate these innovative, evidence-based guidelines with children and families. We need to know if following these child specifc guidelines improves outcomes for children after concussion. Outcomes being evaluated include: duration of symptoms, prevention of repeat injuries, prevention of depression (can occur after a concussion) and overall improvements in the child's quality of life during recovery and after concussion. Activity monitoring devices, as well as Apps for symptom monitoring, will be used to provide information on compliance with guidelines and health information. In order to understand how children with different symptom resolution differ biologically, we will incorporate EEG techniques never used with children with concussion. We will also trial a method of exertion testing in a MRI scanner to look for effects of exercise on the injured brain. Protecting the brains of our children through increased knowledge and decision-making based on sound research is paramount.