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RCT – Does Screen Time Worsen Concussion Symptoms?

November 1, 2021

Written by Clay Smith

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Children with concussion recovered almost 5 days faster with limits on screen time in the first 48 hours after injury.

Why does this matter?
U.S. teens spend up to 7 hours each day looking at some form of computer screen. TV screens are known to be a migraine trigger. Eye strain and light stimulation are probably not best for kids who need cognitive rest. Does screen time worsen concussion symptoms, or is this a form of cognitive rest?

Mom, these video games relax me…I promise!

Design: This was a RCT including 125 children with concussion in the ED, who were randomized to abstain from screen time or use screens ad lib for the first 48 hours after the ED visit. Discharge instructions were otherwise identical, with the exception of telling one group to abstain and the other group to use screens as tolerated.

Results: Abstainers used screens less (130 min/d screen time) and recovered in a median 3.5 days vs screen users (630 min/d screen time), with recovery at a median 8 days; p=0.03.

Implications: Exposure to digital screens right after concussion prolongs recovery. This is a simple intervention we can recommend in addition to light aerobic activity.

Limitations: Screen time was self-reported and subject to recall bias. The study was single center and fell 15 patients short of the recruitment goal, because the COVID-19 pandemic caused early cessation. This is not a limitation – just a point of interest, girls took longer to recover than boys, but this is a known phenomenon.

Effect of Screen Time on Recovery From Concussion: A Randomized Clinical Trial. JAMA Pediatr. 2021 Sep 7;e212782. doi: 10.1001/jamapediatrics.2021.2782. Online ahead of print.

What are your thoughts?