@article{ref1,
title="Concussion recovery timeline of high school athletes using a stepwise return-to-play protocol: age and sex effects",
journal="Journal of athletic training",
year="2019",
author="Tamura, Kaori and Furutani, Troy and Oshiro, Ross and Oba, Yukiya and Ling, Ayaka and Murata, Nathan",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="CONTEXT: Implementation of a stepwise return-to-play (RTP) protocol has become the standard management strategy for high school athletes to ensure a safe RTP after concussion. The detailed characteristics of the recovery timeline throughout the steps of an RTP protocol have not been delineated among the adolescent population. <br><br>OBJECTIVE: To investigate the days spent in each step of the stepwise RTP protocol in an adolescent population and examine the effects of age and sex on recovery time. <br><br>DESIGN: Cross-sectional study. SETTING: Local schools. PATIENTS OR OTHER PARTICIPANTS: Student-athletes from 57 schools. INTERVENTION(S): A total of 726 patients with concussion (age = 15.5 ± 1.2 years, males = 454, females = 272) were included. The 7-step RTP protocol consists of the following steps: (1) complete cognitive rest, (2) full return to school, (3) light exercise, (4) running progression, (5) noncontact training drills and weight training, (6) full-contact practice or training, and (7) return to game play. The data were obtained by certified athletic trainers as a part of statewide standardized concussion-management protocol. MAIN OUTCOME MEASURE(S): Days spent in steps 0 to 6 as well as a breakdown of days by sex and age. <br><br>RESULTS: The average total RTP days were 20.2 ± 13.9. Half of this time was spent in the return-to-school phase (steps 2-3: 10.2 ± 10.0 days). Compared with 17-year-old participants, younger participants (age = 14-16 years) took 3 or 4 days longer to start step 3 and to reach step 6 (<i>P</i> <.05). Females took longer to reach step 6 than males (21.6 ± 15.5 versus 19.3 ± 12.7 days) because they took longer to reach step 3 (14.7 ± 11.4 days) than males (13.0 ± 10.0 days; <i>P</i> <.05). <br><br>CONCLUSIONS: Our study provides an estimated stepwise concussion recovery timeline for adolescent student-athletes. Clearance to start step 3 was the benchmark for the recovery timeline, as the duration of the exercise portion of the protocol was consistent across the age and sex groups.<p /> <p>Language: en</p>",
language="en",
issn="1062-6050",
doi="10.4085/1062-6050-452-18",
url="http://dx.doi.org/10.4085/1062-6050-452-18"
}