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Return to Play Following a Concussion
Brian Richardson, PT, MS, SCS, CSCS Vanderbilt Orthopaedic Institute
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Objectives Discuss the development of the Return to play (RTP) guidelines Discuss the referral process to VOI PT Discuss the RTP guidelines 4/25/2017
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Guideline Development
Collaborative effort VOI PT’s/ATC’s Physicians Evidence based Footer 4/25/2017
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Referral Process Nontraditional sports Symptom free 24 hours
Rodeo Club sports Junior high school Outside Metro/Williamson County Symptom free 24 hours Return to school PT evaluation within 24 hour period Schedule daily or every other day Vestibular involvement Refer to Pi Beta Phi Footer 4/25/2017
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Return to play guidelines
Day 1: Physical Therapy Evaluation History ROM Strength Balance Heart rate/Blood pressure If symptoms occur: Rest 24 hours and then repeat phase If symptoms recur again, refer back to physician Footer 4/25/2017
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Return to play guidelines
Day 1: Aerobic activities Bike or elliptical for 20 minutes Rest 15 minutes and monitor symptoms Treadmill for 20 minutes 70% max heart rate If symptom free, progress to next phase Footer 4/25/2017
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Return to play guidelines
Day 2: Functional activities Jogging/Sprinting Cutting/Lateral movements Situps/Pushups/Burpees Change in elevation/direction If symptom free, progress to next phase Footer 4/25/2017
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Return to play guidelines
Day 3: Sport Specific Activities More intensive Sport dependent Wide receiver: running routes If symptom free, progress to next phase Footer 4/25/2017
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Return to play guidelines
Day 4: Non–contact practice/drills Perform on the practice field Communicate with treating PT/ATC If symptom free, progress to next phase Footer 4/25/2017
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Return to play guidelines
Day 5: Full participation Communicate with the PT/ATC Resume full contact/previous activity level Communicate with physician Footer 4/25/2017
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Conclusions VOI PT: RTP guidelines are a stepwise progression
Symptom free 24 hours Return to school Scheduling: RTP guidelines are a stepwise progression 5 phases Footer 4/25/2017
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Questions? Footer 4/25/2017
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