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Step-wise Return to Sports Participation Following Concussion

Step-wise Return to Sports Participation Following Concussion . JUSTIN WENZEL TRACY CAMPBELL SHANNON GORDON. Research. Protocol Guidelines. Cognitive rest is an essential component of the recovery process and academic accommodations may be necessary

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Step-wise Return to Sports Participation Following Concussion

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  1. Step-wise Return to Sports Participation Following Concussion JUSTIN WENZEL TRACY CAMPBELL SHANNON GORDON

  2. Research

  3. Protocol Guidelines • Cognitive rest is an essential component of the recovery process and academic accommodations may be necessary • Protocol is based on a step-wise exertional progression that is dependent upon the SA remaining asymptomatic upon completion of each phase • ImPACT utilized for baseline and follow-up

  4. Phase 0 Cognitive Exertion • Student-athletes with symptoms following class will be held from academic requirements until asymptomatic 24 hours • Academic arrangements and documentation will be provided for academic advisors and/or professors • Progression to next phase is dependent on the SA remaining asymptomatic

  5. Phase 1Aerobic Exertion • Functional exertion test • Bike 20 minutes @ 70 percent of PMHR • Rest 15 minutes • Monitor symptoms • Incremental Treadmill Test 20 minutes (Leddy et al 2010) • Progression to next phase is dependent on the SA remaining asymptomatic

  6. Phase 2 Functional Exertion • Monitor symptoms • Initial Functional Exertion • Scissor step/quick step • Jog • Lateral shuffle • Backpedal • Sprints • Advanced Functional Exertion • Sit-ups • Burpees • Push-ups • Sprints • Sprints w/intermittent push-ups

  7. Phase 3Sport Specific Exertion • Parameters • Duration approximately 10-15 minutes w/5 minutes rest following session • Monitor symptoms • Progression depends on the student-athlete remaining asymptomatic • Initial • Moderate aerobic exercises specific to sport • Intermediate • Progressively difficult exercises specific to sport • Advanced • Demanding aerobic exercises specific to sport

  8. RTP Sport Progression Examples

  9. RTP Sport Progression Examples

  10. RTP Sport Progression Examples

  11. Phase 4 Limited Practice/Non-contact • Monitor Symptoms • Non-contact training drills dependent upon sport • Progression to next phase is dependent on the SA remaining asymptomatic • Consultation w/ team physician for full clearance

  12. Phase 5Return to Full Practice Participation with Contact • PCSS • Continue to monitor for recurrent symptoms • Full practice participation without restriction • Completion of Phase 5 without symptoms would result in release to full contact participation without restriction

  13. RTP Guidelines Recap • Symptom monitoring at each phase is critical • Progression requires student athlete to be asymptomatic • A step-wise progression ensures the safest return to activity • Symptom exacerbation during a phase will require rest, reassessment and a repeat of that phase

  14. Questions? Thank you to all the athletic trainers and physicians that have contributed

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