Center for Injury Research and Prevention

Pediatric Concussion During COVID-19 Pandemic

May 28, 2020

What can you do at home if you can’t get to a healthcare provider during COVID-19? 

You don’t need organized sports for a concussion to occur, in fact, even a worldwide pandemic that shuts down most of our activities, shopping, schools, and socialization won’t stop concussions from occurring. The good news is that, if a child sustains a concussion and is unable to see his or her primary care provider or a concussion specialist in person, there are actions a child and his or her family can take to take control of the brain injury and feel better.

Telehealth

Many healthcare providers are offering telehealth or video visits, which are similar to a video call on your smartphone or other electronic devices. These video visits offer a platform to maintain continuity of care between patients and providers. In concussion care, the video platform can be very helpful to discuss interval history and update the previously made plan of care.

Self-Help Strategies for Concussion Patients

If a child is in a situation that limits his or her ability to participate in either an in-office healthcare provider visit or a telehealth visit, there are a number of interventions the child can do at home to aid in recovery, under the direction of a healthcare provider:

Symptom-Limited Activity

Gone are the days of sitting in a dark room and doing nothing after a concussion. The updated guidelines support participating in modified activities that don’t provoke significant spikes in symptoms.

That being said, it’s still important to take it easy for a few days (no more than 2-3 days), and it’s okay to participate in activities such as going for a walk, watching TV, or even answering emails and doing school work in a symptom-limited way.  As long as patients pace themselves well and stop when symptoms are provoked and before they significantly worsen.

For example, if a child starts out a walk with a headache that is a 2 out of a 10, he should take a break when the headache goes to a 4 out of a 10. It's important to let symptoms recover back to the 2 out of 10, and then return to that activity. This is a rest-recovery-repeat type of pattern.

Stay Active

More recent data in the concussion literature suggests that exercise may be an effective strategy in not only managing symptoms, but also quite possibly promoting recovery from concussion.

When a child feels up to it, he or she can start slow with a couple of light walks per day starting at 5-10 minutes and increasing gradually to 20-30 minutes in length, avoiding any activity that significantly worsens symptoms or adds a risk of repeat head injury. Advancing to moderate levels of activity as tolerated can then follow, with pacing as described above.

Fitness and staying active have several benefits, including improving blood flow regulation throughout the body, boosting the immune system, and aiding both mood and sleep.

Eat Healthy

It is important to make sure that the child is fueling recovery with a healthy diet, not skipping meals, and paying attention to hydration.

Mental Health

A concussion on top of life’s anxiety-provoking current events can be quite provocative for the worsening of concussion symptoms. Anxiety and depression can occur after a concussion so it is important to be on the lookout for these symptoms. Thankfully, there are many strategies a child can do at home to improve overall mental well-being, even during social distancing. Seeking support from friends and family is important and mindfulness can also be a helpful tool.

Sometimes a child may need professional support, so it is important to seek it out if needed. Families can reach out to their child's primary care or specialist physician for resources. There are many behavioral health therapists that are also offering telehealth visits right now.

Get Good Sleep

Studies have demonstrated that up to 80% of those that have had a concussion report some variation of sleep disturbance including insomnia (difficulty falling asleep or staying asleep), fatigue, and daytime sleepiness. Adequate sleep can improve mood, thinking skills, and immunity, as well as promote recovery.

Some sleep hygiene tips include keeping a consistent sleep and daytime schedule, getting an adequate amount of sleep each night, minimizing daytime napping, making the bedroom dark and cool without electronics (this includes no mobile phones!) and, for some, sleep meditation helps.

Maximizing healthy lifestyle habits and utilizing strategies such as the ones discussed above can promote recovery and will hopefully help a child feel better faster! For more information, please visit CHOP's Concussion Care for Kids: Minds Matter website.