{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T15:34:54Z","timestamp":1777390494100,"version":"3.51.4"},"reference-count":66,"publisher":"SAGE Publications","issue":"14","license":[{"start":{"date-parts":[[2023,2,27]],"date-time":"2023-02-27T00:00:00Z","timestamp":1677456000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000030","name":"centers for disease control and prevention","doi-asserted-by":"publisher","award":["1U01CE002944-01"],"award-info":[{"award-number":["1U01CE002944-01"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Numerous individual studies suggest that rest may have a negative effect on outcomes following concussion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To perform a systematic meta-analysis of the effects of prescribed rest compared with active interventions after concussion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Meta-analysis; Level of evidence, 4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A meta-analysis (using the Hedges g) of randomized controlled trials and cohort studies was conducted to evaluate the effects of prescribed rest on symptoms and recovery time after concussion. Subgroup analyses were performed for methodological, study, and sample characteristics. Data sources were obtained from systematic search of key terms using Ovid Medline, Embase, Cochrane Database of Systematic Reviews, APA PsycINFO, Web of Science, SPORTDiscus, and ProQuest dissertations and theses through May 28, 2021. Eligible studies were those that (1) assessed concussion or mild traumatic brain injury; (2) included symptoms or days to recovery for \u22652 time points; (3) included 2 groups with 1 group assigned to rest; and (4) were written in the English language.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In total, 19 studies involving 4239 participants met criteria. Prescribed rest had a significant negative effect on symptoms ( k = 15; g = \u22120.27; SE = 0.11; 95% CI, \u22120.48 to \u22120.05; P = .04) but not on recovery time ( k = 8; g = \u22120.16; SE = 0.21; 95% CI, \u22120.57 to 0.26; P = .03). Subgroup analyses suggested that studies with shorter duration (&lt;28 days) ( g = \u22120.46; k = 5), studies involving youth ( g = \u22120.33; k = 12), and studies focused on sport-related concussion ( g = \u22120.38; k = 8) reported higher effect sizes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The findings support a small negative effect for prescribed rest on symptoms after concussion. Younger age and sport-related mechanisms of injury were associated with a greater negative effect size. However, the lack of support for an effect for recovery time and the relatively small overall numbers of eligible studies highlight ongoing concerns regarding the quantity and rigor of clinical trials in concussion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration:<\/jats:title>\n                    <jats:p>CRD42021253060 (PROSPERO).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465221150214","type":"journal-article","created":{"date-parts":[[2023,2,27]],"date-time":"2023-02-27T07:17:27Z","timestamp":1677482247000},"page":"3893-3903","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["The Effects of Rest on Concussion Symptom Resolution and Recovery Time: A Meta-analytic Review and Subgroup Analysis of 4329 Patients"],"prefix":"10.1177","volume":"51","author":[{"given":"Anthony P.","family":"Kontos","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; UPMC Sports Medicine Concussion Program, Pittsburgh, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shawn R.","family":"Eagle","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rock","family":"Braithwaite","sequence":"additional","affiliation":[{"name":"Department of Kinesiology and Recreation Administration, Cal Poly Humboldt, Arcata, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0189-2656","authenticated-orcid":false,"given":"Jonathan","family":"Preszler","sequence":"additional","affiliation":[{"name":"UPMC Sports Medicine Concussion Program, Pittsburgh, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Manderino","sequence":"additional","affiliation":[{"name":"UPMC Sports Medicine Concussion Program, Pittsburgh, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rose L.","family":"Turner","sequence":"additional","affiliation":[{"name":"Health Science Library System, University of Pittsburgh, Pittsburgh, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabrina","family":"Jennings","sequence":"additional","affiliation":[{"name":"Inova Sports Concussion Program, Annandale, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alicia","family":"Trbovich","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; UPMC Sports Medicine Concussion Program, Pittsburgh, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert W.","family":"Hickey","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Children\u2019s Hospital of Pittsburgh Division of Emergency Medicine, Pittsburgh, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael W.","family":"Collins","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; UPMC Sports Medicine Concussion Program, Pittsburgh, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"McCrea","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsay D.","family":"Nelson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy","family":"Root","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Medicine, George Washington School of Medicine, Washington, DC, USA; 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