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The Return To Play (RTP) protocol is a supervised stepwise process which involves a gradual increase in activity intensity and duration over the course of 4 – 6 days.  Each phase is 24 hours long.  This gives athletes time to rest and allows for any delayed post-activity signs and symptoms to surface.

As part of the Neurocircuit return to play, clinicians with test the athlete’s reaction time (simple and choice), peripheral awareness, decision making, divided attention and working memory. The testing will enable clinicians to make educated recommendations regarding the athlete’s  readiness to return to play safely.
The clinician will then prepare a report and form for the athletes medical doctor. The report will summarize the results of the testing and formally discharge the patient from the program. It should be noted that only a medical doctor can clear an athlete to return to play.

RETURN TO SPORTS FOLLOWING CONCUSSION
You must complete your recommended period of rest and follow the activity restrictions .You should be symptom free at rest for 5-7 days before attempting STEP 1. There should be approximately 24 hours in between each step. If any symptoms return at any time, stop IMMEDIATELY and rest until you are symptom free for 24 hours. Then return to the previous step. If symptoms do not resolve or get worse, seek medical attention.

STEP 1
LIGHT AND GENERAL CONDITIONING EXERCISES
* NO CONTACT
* Begin with a warm up (stretching / flexibility) for 5-10 minutes.
* Start a stationary bicycle workout of 15 minutes.
Begin Dynavision training, 15 minutes. Measure simple reaction time, choice reaction time, peripheral awareness.
* 50% intensity.

STEP 1A
GENERAL CONDITIONING AND DYNAVISION TRAINING
* NO CONTACT
* Begin with a warm up (stretching / flexibility) for 5-10 minutes.
* Change cardio workout from stationary biking to jogging for 15 minutes.
* Continue Dynavision training, 15 minutes. Measure simple reaction time, choice reaction time, peripheral awareness, divided attention and decision making.
* 50% – 60% intensity.

STEP 2
GENERAL CONDITIONING AND SPORT SPECIFIC WORK DONE INDIVIDUALLY
* NO CONTACT
NO SPINS, DIVES OR JUMPS.
Begin with a warm up (stretching / flexibility) for 5-10 minutes.
* Increase intensity and duration of cardio workout to 20-30 minutes, jogging.
* Start bodyweight resistance training in gym including core and postural exercises.
* Begin sport specific skill work within the workout (passing, shooting), and agility ladder.
Continue Dynavision training, 20 minutes. Measure simple reaction time, choice reaction time, peripheral awareness, divided attention and decision making both before and after exertion.
* 60% – 70% intensity.

STEP 3
GENERAL CONDITIONING SKILLS DONE WITH THERAPIST
NO CONTACT
Increase duration of session to 60 minutes.
Increase intensity and duration of cardio workout to 20-30 minutes, jogging.
Continue practicing sport specific individual skills.
Begin general shooting, kicking or passing drills with therapist.
Start beginner level spins, dives and jumps.
* 75% intensity.

STEP 4
GENERAL CONDITIONING SKILL WORK SND TEAM DRILLS
* NO CONTACT
NO SCRIMMAGES.
* Resume pre-injury duration of practice and team drills.
*Increase resistance training and skill work as required.
*Gradually increase skill level of spins, dives and jumps.
*75-90% intensity
**Athletes must receive clearance from a medical doctor before attempting STEP 5**

STEP 5
FULL PRACTICE WITH BODY CONTACT
* CONTACT
SCRIMMAGES.
* Participate in a full practice.
90-100% intensity.

STEP 6:
RETURN TO COMPETITION

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