{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T11:24:05Z","timestamp":1781090645895,"version":"3.54.1"},"reference-count":43,"publisher":"BMJ","issue":"6","funder":[{"name":"Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health","award":["R21HD086451"],"award-info":[{"award-number":["R21HD086451"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2024,1,21]]},"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>As opposed to postconcussion physical activity, the potential influence of cognitive activity on concussion recovery is not well characterised. This study evaluated the intensity and duration of daily cognitive activity reported by adolescents following concussion and examined the associations between these daily cognitive activities and postconcussion symptom duration.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This study prospectively enrolled adolescents aged 11\u201317 years with a physician-confirmed concussion diagnosis within 72 hours of injury from the emergency department and affiliated concussion clinics. Participants were followed daily until symptom resolution or a maximum of 45 days postinjury to record their daily cognitive activity (intensity and duration) and postconcussion symptom scores.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Participants (n=83) sustained their concussion mostly during sports (84%), had a mean age of 14.2 years, and were primarily male (65%) and white (72%). Participants reported an average of 191 (SD=148), 166 (SD=151) and 38 (SD=61) minutes of low-intensity, moderate-intensity and high-intensity daily cognitive activity postconcussion while still being symptomatic. Every 10 standardised minutes per hour increase in moderate-intensity or high-intensity cognitive activities postconcussion was associated with a 22% greater rate of symptom resolution (adjusted hazard ratio (aHR) 1.22, 95% CI 1.01 to 1.47). Additionally, each extra day\u2019s delay in returning to school postconcussion was associated with an 8% lower rate of symptom resolution (aHR 0.92, 95% CI 0.85 to 0.99).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In adolescents with concussion, more moderate-high intensity cognitive activity is associated with faster symptom resolution, and a delayed return to school is associated with slower symptom resolution. However, these relationships may be bidirectional and do not necessarily imply causality. Randomised controlled trials are needed to determine if exposure to early cognitive activity can promote concussion recovery in adolescents.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bjsports-2023-107601","type":"journal-article","created":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T01:10:18Z","timestamp":1707700218000},"page":"328-333","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Exploring the association between cognitive activity and symptom resolution following concussion in adolescents aged 11\u201317 years"],"prefix":"10.1136","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4019-0999","authenticated-orcid":false,"given":"Jingzhen","family":"Yang","sequence":"first","affiliation":[{"name":"The Abigail Wexner Research Institute at Nationwide Children\u2019s Hospital, Columbus, Ohio, USA"},{"name":"Department of Pediatrics, The Ohio State University College of Medcine, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enas","family":"Alshaikh","sequence":"additional","affiliation":[{"name":"The Abigail Wexner Research Institute at Nationwide Children\u2019s Hospital, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nichole","family":"Asa","sequence":"additional","affiliation":[{"name":"University of Washington, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"VonDeylen","sequence":"additional","affiliation":[{"name":"The Abigail Wexner Research Institute at Nationwide Children\u2019s Hospital, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil","family":"Desai","sequence":"additional","affiliation":[{"name":"The Abigail Wexner Research Institute at Nationwide Children\u2019s Hospital, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hudson 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