%0 Systematic Review
%T Early intervention treatment in the first 2 weeks following concussion in adults: A systematic review of randomised controlled trials.
%A Moore S
%A Musgrave C
%A Sandler J
%A Bradley B
%A Jones JRA
%J Phys Ther Sport
%V 65
%N 0
%D 2024 Jan 3
%M 38065015
%F 2.92
%R 10.1016/j.ptsp.2023.11.005
%X <B>OBJECTIVE: </B>International guidelines support a repertoire of therapeutic interventions that may assist recovery following concussion. We aimed to systematically review the efficacy of early pharmacological and non-pharmacological interventions initiated within two weeks of injury on symptoms and functional recovery of adults with concussion.<BR><B>METHODS: </B>We conducted a Systematic Review (SR) of Randomised Controlled Trials (RCTs) without meta-analysis utilising the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was performed of four databases. Study inclusion criteria were adult participants diagnosed with concussion and commencing active intervention within 14 days of injury.<BR><B>CONCLUSIONS: </B>Of 7531 studies identified, 11 were included in the final review. Six studies were rated as high-risk of bias, three with some concerns and two as low-risk of bias. We found no evidence to support specific pharmacotherapeutic management to hasten the natural recovery time-course. Two studies reported significant improvement in selected concussion symptoms following manual therapy (at 48-72 hours post-treatment) or telephone counselling interventions (at 6 months post-injury). No high quality RCTs demonstrate superior effects of early therapeutic interventions on concussion recovery in the first 2 weeks. We advocate future research to examine impacts of health-clinician contact points aligned with symptom-specific interventions.