Return to play after a concussion – Part 2

Graduated Return to Play (GRTP) 

The GRTP should be undertaken on a case by case basis and with the full cooperation of the player and their parents/guardians.

Where a club/school has their own medical resources the GRTP process should be carried out by the club/school coach, and overseen by the club/school health care professional/doctor. Parents should where possible also be actively involved in the process.

A summary of the GRTP is shown in the following diagram.

rtp-part-2

Before a player can commence the exercise elements of the GRTP i.e. Stage 2, they must be symptom free for a period of 24 hours (adult) or 48 hours (U19) (This is Level 1). As emphasised above honest feedback must be obtained either from the player, or their supporting network.

The player can then progress through each stage as long as no symptoms or signs of concussion return. Where the player completes each stage successfully without any symptoms the player would normally proceed through each stage on successive days. In U19s, progression should take 2 days for each stage.

Please note, I recommend the coach or a qualified person i.e. sport therapists, to conduct the GRTP to ensure accuracy and continuity. Team Medic can arrange the GRTP if required.

Before a player can commence the exercise elements of the GRTP i.e. Stage 2, they must be symptom free for a period of 24 hours (adult) or 48 hours (U19) (This is Level 1)

The player can then progress through each stage as long as no symptoms or signs of concussion return. Where the player completes each stage successfully without any symptoms the player would normally proceed through each stage on successive days. In U19s, progression should take 2 days for each stage.

If any symptoms occur while progressing through the GRTP protocol, the player must consult with their medical practitioner before returning to the previous stage and attempting to progress again after a minimum 24-hour (adult) or 48 hour (U19) period of rest, without the presence of symptoms.

If it is not feasible for the coach to conduct Levels 2 – 4, these may be done by the player in their own time or in children supervised by parents with appropriate guidance. Alternatively the protocol may simply be extended with each level being conducted by the coach at training sessions.

On completion of Level 4 the player may resume full contact practice (Level 5) with Medical Practitioner clearance.

It is the player’s or parent’s responsibility to obtain medical clearance before returning to play.

Schools and clubs are advised to keep a record of the player’s or parent’s confirmation that clearance has been obtained and a doctor’s letter is not necessarily required.

On completion of Level 5 without the presence of symptoms, the player may return to playing in full contact rugby games (Level 6).

 

These Concussion resources have been developed based on the Zurich Guidelines published in the Consensus Statement on Concussion in Sport, and adapted for American Football, and should be used for information purposes only and not solely relied upon with seeking further advice.

The information contained in this resource is intended for educational purposes only and is not meant to be a substitute for appropriate medical advice or care. If you believe that you or someone under your care has sustained a concussion we strongly recommend that you contact a qualified health care professional for appropriate diagnosis and treatment. The authors have made responsible efforts to include accurate and timely information. However they make no

 

representations or warranties regarding the accuracy of the information contained and specifically disclaim any liability in connection with the content on this site.

 

By | 2017-01-20T13:24:28+00:00 September 9th, 2016|Uncategorized|0 Comments

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