• Kathryn J Schneider, John J Leddy, Kevin M Guskiewicz, Tad Seifert, Michael McCrea, Noah D Silverberg, Nina Feddermann-Demont, Grant L Iverson, Alix Hayden, and Michael Makdissi.
• Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.
• Br J Sports Med. 2017 Jun 1; 51 (12): 930-934.

Aim Or ObjectiveThe objective of this systematic review was to evaluate the evidence regarding rest and active treatment/rehabilitation following sport-related concussion (SRC).DesignSystematic review.Data SourcesMEDLINE (OVID), CINAHL (EbscoHost), PsycInfo (OVID), Cochrane Central Register of Controlled Trials (OVID), SPORTDiscus (EbscoHost), EMBASE (OVID) and Proquest DissertationsandTheses Global (Proquest) were searched systematically.Eligibility Criteria For Selecting StudiesStudies were included if they met the following criteria: (1) original research; (2) reported SRC as the diagnosis; and (3) evaluated the effect of rest or active treatment/rehabilitation. Review articles were excluded.ResultsTwenty-eight studies met the inclusion criteria (9 regarding the effects of rest and 19 evaluating active treatment). The methodological quality of the literature was limited; only five randomised controlled trials (RCTs) met the eligibility criteria. Those RCTs included rest, cervical and vestibular rehabilitation, subsymptom threshold aerobic exercise and multifaceted collaborative care.Summary/ConclusionsA brief period (24-48 hours) of cognitive and physical rest is appropriate for most patients. Following this, patients should be encouraged to gradually increase activity. The exact amount and duration of rest are not yet well defined and require further investigation. The data support interventions including cervical and vestibular rehabilitation and multifaceted collaborative care. Closely monitored subsymptom threshold, submaximal exercise may be of benefit.Systematic Review RegistrationPROSPERO 2016:CRD42016039570.© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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