![]() 60) in our sample, and (3) we evaluated their combined predictive contribution (ie, joint effect) to postconcussion symptoms. We included both self- and parent-reported screen time as predictors, for 3 reasons: (1) the scale that more accurately reflects a participant’s actual screen time is unclear, (2) self- and parent-reported screen time correlated only moderately (Spearman’s r =. To examine the association between screen time and postconcussion symptoms over time, we fit 4 generalized least squares models, 1 for each of the 4 HBI outcome measures: self-reported somatic and cognitive symptoms and parent-reported cognitive and somatic symptoms. 10– 13ĭescriptive statistics summarized baseline characteristics. Finally, understanding the importance of screen time relative to other known predictors of recovery, such as preinjury symptoms and early physical activity, would help contextualize clinical recommendations. 9 The design of the Macnow et al study (ie, 2-arm clinical trial) 8 provides little insight into the association of concussion recovery with the full naturalistic range of screen time. Relatedly, the mechanisms underlying any benefit from screen time restrictions are unknown however, they may be associated with increased physical activity, which is known to accelerate concussion recovery. Whether less screen time facilitates recovery from concussion specifically or benefits the well-being of youth regardless of concussion (eg, decreased sedentary behavior) is unclear. ![]() The effects of time spent on screens after the first 48 hours postconcussion remain unknown. Although screen time within the first 48 hours postinjury could contribute to temporary symptom exacerbation, its longer-term impact has not been examined empirically. The long-term effects of screen time on concussion recovery are still unknown. Several important questions about screen time after concussion remain unanswered. The group permitted to use screens as tolerated had a longer median time until recovery (8.0 days ) than the group instructed to abstain from screen time (3.5 days ). 8 Symptom ratings were collected daily for 10 days. 8 Patients aged 12 to 25 years ( N = 125) who presented to an emergency department (ED) with concussion were permitted screen time as tolerated or instructed to abstain for the first 48 hours postinjury. 5– 7 The impact of screen time after concussion had not been empirically studied until a recent randomized controlled trial by Macnow et al. 1 Some clinical practice guidelines recommend avoiding screens for 1 to 2 days before gradually resuming use as tolerated, 2 whereas other guidelines mention gradually returning to screen time in the context of return-to-school strategies 3 or imply that screen time restrictions are a component of “cognitive rest.” 4 However, advising complete cognitive rest (“cocooning”), including a prohibition on screen time, could conceivably have negative effects on children and adolescents (eg, social isolation, psychological distress). Physicians often recommend that children and adolescents limit or avoid use of computers, televisions, phones, and other devices with screens after concussion.
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