Concussion Management

 

 

 

 

 

Return to School Activities

 

Once a student diagnosed with a concussion has been symptom free at rest for at least 24 hours, a private medical provider may choose to clear the student to begin a

graduated return to activities. If a district has concerns or questions about the private medical provider’s orders, the district medical director should contact that provider to

discuss and clarify. Additionally, the medical director has the final authority to clear students to participate in or return to extra-class physical activities in accordance with

8NYCRR 135.4(c)(7)(i).

Students should be monitored by district staff daily following each progressive challenge, physical or cognitive, for any return of signs and symptoms of concussion.

Staff members should report any observed return of signs and symptoms to the school nurse, certified athletic trainer, or administration in accordance with district policy. A

student should only move to the next level of activity if they remain symptom free at the current level. Return to activity should occur with the introduction of one new activity

each 24 hours. If any post concussion symptoms return, the student should drop back to the previous level of activity, then re-attempt the new activity after another 24 hours have

passed. A more gradual progression should be considered based on individual circumstances and a private medical provider’s or other specialist’s orders and

recommendations.

The following is a recommended sample return to physical activity protocol based on the Zurich Progressive Exertion Protocol:

http://sportconcussions.com/html/Zurich%20Statement.pdf

 

Phase 1- low impact, non-strenuous, light aerobic activity such as walking or riding a stationary bike. If tolerated without return of symptoms over a 24 hour period proceed

to;

Phase 2- higher impact, higher exertion, and moderate aerobic activity such as running or jumping rope. No resistance training. If tolerated without return of symptoms over a 24

hour period proceed to;

Phase 3- Sport specific non-contact activity. Low resistance weight training with a spotter. If tolerated without return of symptoms over a 24 hour period proceed to;

Phase 4- Sport specific activity, non-contact drills. Higher resistance weight training with a spotter. If tolerated without return of symptoms over a 24 hour period proceed to;

Phase 5- Full contact training drills and intense aerobic activity. If tolerated without return of symptoms over a 24 hour period proceed to;

Phase 6- Return to full activities without restrictions.

 

For further information please visit:  http://www.nysphsaa.org/SafetyResearch

 

For Heads Up CDC information: http://www.cdc.gov/headsup/youthsports/training/index.html