Moderate screen time in the first 3 days after concussion is linked to faster recovery, with an average 141 minutes of daily use speeding up symptom resolution by 35%, finds a study of 80 concussed teens published online in the British Journal of Sports Medicine.
Recovery above or below this seems to be slower, the findings suggest, prompting the researchers to conclude that rather than total avoidance, a balanced level of use may be helpful.
Prolonged or intense use of smartphones, computers/tablets, TV watching and gaming may cause eye strain, cognitive overload, and sleep disruption, potentially worsening the symptoms of concussion, note the researchers.
And the limited research that has been published suggests that avoiding screen time for the first 48 hours may help to shorten the recovery period by several days. But these studies have relied on self report and have tended not to differentiate screen types, they add.
To provide more objective and granular detail on the impact of screen time on recovery, the researchers analysed data from a study of 80 concussed 11 to 17 year olds who were enrolled within 72 hours of their injury.
The teens were monitored until their symptoms cleared up, or for 45 days, whichever came first. Symptom resolution was determined from daily completed Post-Concussion Symptom Scale surveys and confirmed by a certified athletic trainer or doctor.
Cognitive activity over the first 7 days following the injury was monitored using a wearable camera that automatically captured high resolution images every 30 seconds. Cognitive activity included listening to music, watching TV, texting, using a computer/tablet, gaming, socialising, studying and driving.
For the current study, the researchers focused on 4 types of screen time activity: smartphone use; watching TV; computer/tablet use; and gaming, including on video and handheld devices.
Average screen time rose in tandem with symptom severity. During the first week after injury it averaged 358.4 minutes/day. Smartphone use was the most common (224.4 mins/day), followed by watching TV (203.5 mins/day), computer/tablet use (112.8 mins/day) and gaming (59.7 mins/day).
After adjusting for potentially influential factors, an average screen time of 141 mins/day during the first 3 days after a concussion was associated with a 35% faster rate of symptom resolution than an average of 260 mins/day.
Further exploratory analyses indicated that symptoms cleared up faster among those spending 120–240 mins/day on screens than those spending less than 120 mins/day or more than 240 mins/day.
Specifically, symptom resolution was more than twice as fast among teens clocking up screen time of 120–240 mins/day than among those clocking up less than 120 mins/day, and 1.5 times as fast among those clocking up more than 240 mins/day.
When assessed by screen type, symptoms cleared up more than twice as fast among teens who averaged 120-240 daily minutes of smartphone use than among those using their smartphones for fewer than 120 mins/day or more than 240 mins/day.
Similarly, symptoms resolved 3 times as fast among those watching TV for 60–120 mins/day than those watching it for more than 120 mins/day.
Computer/tablet use and gaming, however, weren't significantly associated with faster recovery.
This is an observational study, and as such, no firm conclusions can be drawn about cause and effect, added to which the researchers highlight various limitations to their findings.
For example, the sample size was small, and the content of screen time, screen brightness, resolution, colour settings, the use of blue-light-blocking glasses and participants' cognitive engagement weren't measured, all of which may affect recovery.
Nor was screen use during school hours recorded, and while total daily screen time was measured, its timing wasn't.
"While our findings add to the limited evidence on screen time and acute concussion recovery in youth, standardised definitions, uniform measurement, and randomised controlled trials (RCTs) are needed. Further research should also explore the context and content of screen use to better understand its impact on concussion recovery in youth," emphasise the researchers.
But they nevertheless conclude: "Rather than advising complete screen avoidance, clinicians may consider recommending a daily screen time target of about 141 mins to support recovery."
