A graduated return to play protocol was reported at the 4th International Conference in Sport held in Zurich.
Number of steps: 6
Rules:
(1) The protocol starts when the person has fully recovered from signs and symptoms of the concussion (step 1).
(2) The person proceeds through a series of steps, each requiring a minimum of 24 hours.
(3) If the person shows signs or symptoms of concussive injury at a stage, then the person rests 24 hours or longer (until asymptomatic) then repeats the previous stage again before trying the failed stage again.
(4) The person is observed at each stage and must be cleared before progressing.
(5) The entire protocol takes about a week to complete in most cases. No athlete should return to play on the day of concussive injury.
Stage
Status
Restrictions
1
recovering
no or minimal activity
2
light aerobic exercise to increase heart rate
no resistance training
3
sports-related exercise with some movement
no head impact activitieis
4
non-contract drills with cognitive load to build stamina and coordination
progressive resistance training
5
full-contact practice
6
return to full play
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