Evidence map›Paper›PMID 40254050›Full record

Trial reportThe Journal of pediatrics2025

Impact of Early Activity and Behavioral Management on Acute Concussion Recovery: A Randomized Controlled Trial.

Danny George Thomas, Holly Erpenbach, Clair N Smith, Robert W Hickey, Dana Waltzman, Juiliet Haarbauer-Krupa, Lindsay D Nelson, Charity G Patterson, Michael McCrea, Michael W Collins and 1 more

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The Journal of pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03869970 (Active Injury Management), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03869970 nacompletednot on this map

Active Injury Management (AIM) After Pediatric Concussion

TypeinterventionalSponsorMedical College of WisconsinRan2019 to 2023Enrolled237ConditionsBrain ConcussionArmsREST, ACTIVITY, mHEALTH
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Danny George ThomasDepartment of Pediatrics, Medical College of Wisconsin, Milwaukee, WI. Electronic address: dthomas@mcw.edu.
Holly ErpenbachDepartment of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.
Clair N SmithDepartment of Physical Therapy and SHRS Data Center, University of Pittsburgh, Pittsburgh, PA.
Robert W HickeyDepartment of Pediatrics, University of Pittsburgh, Pittsburgh, PA.
Dana WaltzmanCenters for Disease Control and Prevention, Atlanta, GE.
Juiliet Haarbauer-KrupaCenters for Disease Control and Prevention, Atlanta, GE.
Lindsay D NelsonDepartments of Neurosurgery and Neurology, Medical College of Wisconsin, Milwaukee, WI.
Charity G PattersonDepartment of Physical Therapy and SHRS Data Center, University of Pittsburgh, Pittsburgh, PA.
Michael McCreaDepartments of Neurosurgery and Neurology, Medical College of Wisconsin, Milwaukee, WI.
Michael W CollinsDepartment of Orthopedics, University of Pittsburgh, Pittsburgh, PA.
Anthony P KontosDepartment of Orthopedics, University of Pittsburgh, Pittsburgh, PA.

Funding

Intramural CDC HHS CC999999NCIPC CDC HHS U01 CE002939
6 · The paper itself

Abstract

objectiveTo determine the efficacy of early physical activity and behavioral management for acute concussion in pediatric patients. STUDY

designA multicenter, prospective, 2 × 2 factorial randomized controlled trial was conducted among patients aged 11-24 years who presented within 72 hours of injury. Participants were randomized into 4 groups based on early physical activity (or usual care [UC]) and behavioral management (or none). The early activity (EA) group was encouraged to meet step targets despite symptoms. The primary outcomes were postconcussion symptom severity and quality of life at 14 days postenrollment.

resultsA total of 239 participants were randomized, and 210 completed all study procedures. The EA group demonstrated higher daily step counts compared with the UC group. However, no significant differences were observed in postconcussion symptom severity or quality of life at 14 days between groups. The EA group experienced higher daily postconcussion symptom severity during the first 7 days and took longer to recover compared with the UC group. Behavioral management showed no effect on outcomes.

conclusionsEarly prescribed physical activity and behavioral management did not improve postconcussion outcomes in the first 2 weeks following injury. Early prescribed activity despite symptoms was associated with delayed symptom resolution.

trial registrationClinicalTrials.gov NCT03869970.

Indexed as

Behavior TherapyBrain ConcussionExerciseExercise TherapyPost-Concussion SyndromeAdolescentChildFemaleHumansMaleProspective StudiesQuality of LifeRecovery of FunctionTreatment OutcomeYoung Adultbehavioral interventionconcussionphysical activityrandomized trial

Identifiers

PMID40254050
PMCPMC13249091

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.