Screen Time Tied to Slower Concussion Recovery Time in Youth

By Lisa Rapaport

September 15, 2021

(Reuters Health) - Youth who sustain concussions may have a faster recovery when they abstain from screen time during the first 48 hours after injury, a randomized clinical trial suggests.

Researchers studied 125 patients aged 12-25 treated in pediatric and adult emergency departments within 24 hours of sustaining a concussion. Patients were randomized to groups that permitted (n=66) or prohibited (n=59) screen use for 48 hours after injury. The primary goal of the study was to assess the effect of screen time exposure on total days to resolution of symptoms as defined by a total score of 3 points or lower on the Post-Concussive Symptom Scale (PCSS).

Participants permitted screen time reported median screen time of 630 minutes during the 10-day follow-up period, compared with 130 minutes in the group that was asked to abstain from screen time, researchers report in JAMA Pediatrics.

Youth permitted screen time had significantly longer median recovery time (8.0 days) than those prohibited from having screen time (3.5 days).

"Our study confirmed what many clinicians have assumed for years without specific data - that screen time abstinence is helpful for recovery from concussion," said lead study author Dr. Theodore Macnow, medical director of UMass Memorial Children's Medical Center Pediatric Emergency Department in Worcester.

The mechanism of harm still isn't certain, Dr. Macnow said by email.

It might be due in part to screen time negatively impacting sleep, Dr. Macnow said.

"While our participants slept the same amount in the study, it is possible the screen-time-permitted group had a lower quality of sleep, which is important in concussion recovery," he said.

Youth who spent more time on screens might also be spending less time engaged in physical activity that can be beneficial to concussion recovery, he added.

Those in the screen time group were significantly less likely to recover by the end of the 10-day follow-up period (HR 0.51) than those who were not permitted screen time. Females were also significantly less likely to recover during the study than males (HR 0.34).

Limitations of the study include its single center design, which may limit generalizability. The convenience sample enrolled during the COVID-19 pandemic was also smaller than planned, and the assessment of screen time was based on self-reported usage, rather than independently verified measurements.

Still, it's not surprising that avoiding screens in the first few days after injury would improve concussion recovery times, and many clinicians already advise patients to do this, said Dr. Sara Chrisman, an associate professor in adolescent medicine at the University of Washington and Seattle Children's Research Institute who wrote an editorial accompanying the study.

"Based on this study, clinicians should recommend screen time limits for 48 hours after concussive injury, and then have their patients start back a little each day," Dr. Chrisman said by email. "It's important to remember that limiting screens for longer than 48 hours may not be beneficial, as previous studies have found extended periods of rest after concussion are detrimental to recovery."

SOURCE: and JAMA Pediatrics, online September 7, 2021.