Guidelines for Returning to an Activity after a Concussion

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Note: Each step should be completed with no concussion symptoms before proceeding to the next step. 

  1. No activity, complete rest with no symptoms.
  1. Light exercises: walking or stationary cycling with no symptoms.
  1. Sport specific activity without body contact and no symptoms.
  1. Practice without body contact and no symptoms. Resume resistance training.
  1. Practice with body contact and no symptoms.
  1. Return to game play with no symptoms.

Note:
1) If symptoms return at any time during the rehabilitation process, wait until asymptomatic for 1 full day, then re-start at the previous step
2) Never return to competition with symptoms
3) Do not use "smelling salts"
4) When in doubt, sit them out

References:
Karen M. Johnston, Paul McCrory, N. Mohtadi, W. Meeuwise. Evidence Based review of concussion: Clinical Science. Clinical J. of Sport Medicine, 2001;11(3):150-159.
Paul McCrory, Karen M. Johnston, N. Mohtadi, W. Meeuwise. Evidence Based review of concussion: Basic Science. Clinical J. of Sport Medicine. 2001;11(3):160-165.
"Concussion in Sport Group". Karen M. Johnston (Chair). Summary and agreement statement of the 1st International Conference on Concussion in Sport, Vienna 2001. The Physician and Sportsmedicine, 2002;30(2):57-63.
"Concussion in Sport Group", Karen M. Johnston (Chair). Summary and agreement statement of the 1st International Conference on Concussion in Sport, Vienna 2001. British Journal of Sport Medicine. 2002;36(1 ):6-1 O.
"Concussion in Sport Group". Karen M. Johnston (Chair). Summary and agreement statement of the 1st International Conference on Concussion in Sport, Vienna 2001. Clinical Journal of Sport Medicine. 2002;12(1):6-11