Progression through return-to-sport and return-to-academics guidelines for concussion management and recovery in collegiate student athletes: findings from the Ivy League-Big Ten Epidemiology of Concussion Study

Abstract
Objective: To examine the progression of collegiate student athletes through five stages of a return-to-activity protocol following sport-related concussion (SRC).
Methods: In a multisite prospective cohort study, we identified the frequency of initial 24-48 hours physical and cognitive rest, and the sequence of (1) symptom resolution and return to (2) exertion activity, (3) limited sport, (4) full sport and (5) full academics. In resulting profiles we estimated the likelihood of return to full sport ≤14 days or prolonged >28 days and tested for variability based on timing of the stages.

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