Post-concussion screen time duration and type and its association with symptom resolution in youth aged 11–17 years

OBJECTIVE: To examine associations in youth between objectively measured screen time (duration and type) during the first week post concussion and time to symptom resolution. STUDY DESIGN: We retrospectively analysed a school-going cohort aged 11-17 enrolled within 72 hours of sustaining a concussion. Participants wore a Narrative Clip (mini-camera) for 7 days to objectively capture out-of-school screen time, measured in minutes per standardised 960-minute day. Screen time use was classified as smartphone, television (TV), computer/tablet or gaming. The outcome was days to symptom resolution. RESULTS: Among 80 participants (mean age 14.3 years, 65.0% male), average daily post-concussion screen time was 358.4 min (SD=329.9). Smartphone use was most common (224.4 min/day), followed by watching TV (203.5 min/day), computer/tablet use (112.8 min/day) and gaming (59.7 min/day). In adjusted Cox proportional hazards models, an optimal median of 141 min/day during the first 3 days post concussion was associated with a 1.35-fold higher rate of symptom resolution compared with 260 min/day (95% CI 1.03 to 1.77). Exploratory analyses showed that moderate screen time (120-240 min/day) was associated with faster symptom resolution compared with more restricted use of <120 min/day (HR=2.27, 95% CI 1.20 to 4.29) or prolonged use of >240 min/day (HR=1.58, 95% CI 0.86 to 2.93). Similar trends were observed for smartphone and TV use. CONCLUSIONS: In this cohort of youth, moderate screen time, about 141 min/day during the first 3 days following concussion, was associated with faster symptom resolution. Rather than complete avoidance, clinicians may consider recommending this balanced level of use to support concussion recovery.