Complete cognitive rest – no school, no homework, 1 No activity no reading, no texting, no Recovery video games, no computer work. Relax previous restrictions Gradual Gradual controlled increase in on activities and add back 2 reintroduction of subsymptom threshold cognitive for short periods of time cognitive activity activities. (5-15 minutes at a time). Homework at home Homework in longer Increase cognitive stamina by 3 before school work increments (20-30 minutes repetition of short periods of at school at a time). self-paced cognitive activity. Re-entry into school with Part day of school after accommodations to permit tolerating 1-2 cumulative 4 School re-entry controlled subsymptom hours of homework at threshold increase in cognitive home. load. Gradual Increase to full day of Accommodations decrease as 5 reintegration into school. cognitive stamina improves. school Resumption of full Introduce testing, catch 6 Full return to school. cognitive workload with essential work. Return to Play Protocol Athletic trainers or other appropriate medical providers
1 No activity Complete cognitive rest – no school, no homework, no reading, no texting, no video games, no computer work. Recovery 2 Gradual reintroduction of cognitive activity Relax previous restrictions on activities and add back for short periods of time (5-15 minutes at a time). Gradual controlled increase in subsymptom threshold cognitive activities. 3 Homework at home before school work at school Homework in longer increments (20-30 minutes at a time). Increase cognitive stamina by repetition of short periods of self-paced cognitive activity. 4 School re-entry Part day of school after tolerating 1-2 cumulative hours of homework at home. Re-entry into school with accommodations to permit controlled subsymptom threshold increase in cognitive load. 5 Gradual reintegration into school Increase to full day of school. Accommodations decrease as cognitive stamina improves. 6 Resumption of full cognitive workload Introduce testing, catch with essential work. Full return to school. Return to Play Protocol Athletic trainers or other appropriate medical providers