A systematic review of randomized controlled trials has found limited evidence to support the use of early interventions, both pharmacological and non-pharmacological, in the first two weeks following a concussion. The review, encompassing 11 studies, highlights the need for further high-quality research to determine effective strategies for hastening recovery during this critical period.
The analysis, adhering to PRISMA guidelines, scrutinized studies where interventions commenced within 14 days of a concussion diagnosis in adult participants. A comprehensive search across four databases initially identified 7531 studies, which were then filtered based on strict inclusion criteria.
Lack of Support for Pharmacological Interventions
The review revealed a lack of evidence supporting specific pharmacotherapeutic management aimed at accelerating the natural recovery process after a concussion. This suggests that commonly used medications may not significantly impact recovery during the initial two weeks post-injury.
Modest Benefits from Non-Pharmacological Approaches
Two studies indicated potential benefits from non-pharmacological interventions. One study reported significant improvements in selected concussion symptoms following manual therapy administered 48 to 72 hours post-treatment. Another study found that telephone counseling interventions led to improvements at 6 months post-injury. However, the review noted that the overall quality of evidence supporting these findings was not high, with most studies exhibiting a high risk of bias.
Methodological Concerns and Future Directions
The review highlighted significant methodological limitations across the included studies. Six studies were rated as having a high risk of bias, three had some concerns, and only two were considered to have a low risk of bias. These limitations underscore the need for more rigorous and well-designed trials to evaluate the efficacy of early concussion interventions.
The authors advocate for future research to focus on the impacts of health-clinician contact points aligned with symptom-specific interventions. This approach could potentially lead to more targeted and effective strategies for managing concussion in the early stages of recovery.
