Defining Rest Post-Concussion Using Fitbit Technology

Background/Purpose:  Current post-concussion treatment is highly variable across sport settings and within the NCAA. A common focus of treatment is to minimize symptoms. Common symptoms include visual-disturbances, headache, and difficulty sleeping. A common theme post-concussion includes limiting activity, however, there is ambiguity as to what this means and limited research to define it. Furthermore, resting following concussion has been correlated with symptom resolution. The purpose of this research was to determine a baseline on sleep quality and quantity, daily activity on a college campus while attending classes and activity when confined-to-the-home in a healthy college-aged population. This data may assist in developing a post-concussion treatment protocol by quantifying “rest” as a step count and by examining sleep that college-students achieve when not experiencing post-concussion recovery.

Method: Observational, gathering of normal daily activity and sleep-patterns of students on a college campus in Ogden, Utah. Participants included 19 (n=16 females; n=5 males) healthy college-aged participants (26.7+/-6.2 years; 169.5 cm; 78.2+/-25.2kg). Students wore the Fitbit watch for the same 4-week (28-day) period during spring semester. Daily activity was defined as total number-of-steps in one 24-hour period. The same procedure was used for limited activity while confined-to-the-home setting for 24-hours. Sleep quality was defined as number-of-times-awakened during the night measured by restlessness or periods awake sensed by the Fitbit. Sleep quantity was defined as total-number-of-sleep-hours in a 24-hour period; the Fitbit was "put-to-sleep" by the participant.

Analysis/Results:  Average daily-activity for college-aged participants was 6781.5 +/- 2548.17 steps; Average daily-activity when confined-to-the-home was 662.80 +/- 48.5 steps; Average sleep quantity was 7.12 +/- 0.88 hours; Average restlessness at night was 26.5 +/- 6.10 times awakened; Mean steps per credit hour was 492.30 +/- 112.13 steps.

Conclusions:  Defining the average activity levels of college-students stands to inform sports medicine practitioners about prescribing physical rest as part of the recovery process of an athlete post-concussion; navigating a college campus to attend classes and living the life of a student is associated with a baseline level of activity. What's more, defining rest by limiting the number of steps an athlete should take daily is an important aspect of developing a comprehensive post-concussion care plan, as symptomatic activity has been correlated with cell death. Finally, assessing sleep trends via the Fitbit can also inform post-concussion care as gaining quality sleep has been correlated with symptom resolution. This and additional research can inform a comprehensive multidisciplinary approach to post-concussion care.