An evaluation of the interventions used in post-concussion syndrome: A systematic review

Background: Post-concussion syndrome (PCS) affects 15-25% of mild traumatic brain injury (mTBI) patients resulting in such symptoms as memory loss, dizziness and headache. This review focuses on the three interventions most used in clinical practice: rest, information giving and cognitive behavioural therapy (CBT). Rest is increasingly being questioned as a treatment in many areas of medicine but is still promoted in concussion management. Information giving is an integral part of a medical consultation but has not proven to help PCS symptoms. Lastly, CBT has a firm founding in psychiatry and is increasingly used in mTBI. This review will look at the evidence available for all three of these interventions in the context of PCS.

Method: Systematically reviewing studies from; MEDLINE, Embase, PsycINFO and PubMed for original, non-observation studies published 1998- 2019 including adults with mTBI in relation to the intervention of rest, CBT or information giving. Excluding sports concussion studies.

Results: Of the 20,902 studies identified, 14 were included in this review. Three rest papers, four CBT papers and seven for information giving. Two of the three rest studies showed no effect of rest on PCS. The CBT studies that focused on acute PCS all found the intervention effective. The information giving studies yielded inconclusive results.

Conclusions: Of the three interventions assessed, only CBT has proven effective in the treatment of PCS. Rest does not have sufficient evidence to support its promotion. Information giving will remain common practice, but inadequate evidence was found to support its use in reducing PCS symptoms.


Nisha Chauhan

Abstract | PDF

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