Patient presents 48 hours post-injury with a confirmed diagnosis of sport-related concussion sustained during a Saturday conference matchup. Loss of consciousness was brief (approximately 8 seconds) with no evidence of skull fracture or intracranial hemorrhage on cleared CT imaging.
SCAT6 symptom burden scored 42 of 132 at intake with prominent vestibular-ocular involvement. VOMS screening reproduced symptoms on smooth pursuit and near-point convergence. Patient is compliant, well-supported by athletic training staff, and expresses reasonable expectations regarding timeline.
Plan proceeds through a graduated six-stage progression with each stage requiring a minimum 24-hour symptom-free window before advancement. Any recurrence of symptoms drops the athlete back one stage.
| Week | Phase & Target | Permitted Activity | Exertion Ceiling |
|---|---|---|---|
01Oct 14–20 |
Symptom-Limited Rest
Cognitive and physical de-load.
|
Class attendance suspended; screen time capped at 30 min blocks with 1-hr rest. Dark, quiet environment prioritized. Light walking for ≤ 10 min twice daily if tolerated. | < 40% HRmax |
02Oct 21–27 |
Light Aerobic
Reintroduce blood flow, no head movement.
|
Stationary bike 15–20 min, low resistance. Academic workload resumed at 50% with extended deadlines. No weightlifting, no impact, no reading past symptom threshold. | 55–65% HRmax |
03Oct 28–Nov 3 |
Sport-Specific
Linear movement, no rotational load.
|
Jogging, position-specific footwork drills, route running without ball. Full academic load restored. Begin vestibular therapy 3× weekly with Dr. Patel. | 70–80% HRmax |
04Nov 4–10 |
Non-Contact Training
Complex movement, cognitive load.
|
Full practice drills without contact. Resistance training resumed with progressive load. Passing drills, cutting, ball tracking. Reaction-time batteries integrated. | 80–90% HRmax |
05Nov 11–17 |
Full-Contact Practice
Medical clearance required to begin.
|
Full-contact practice after medical clearance obtained. Monitored reps progressing from bag work to controlled team periods. Daily symptom check-in with training staff. | Maximal |
06Nov 18–24 |
Return to Competition
Unrestricted game participation.
|
Full return to competitive play pending final neurocognitive clearance, neurologist sign-off, and two consecutive symptom-free full-contact practices. | Unrestricted |
If any of the following present at any point during this protocol, cease activity immediately and contact the on-call team physician or proceed to the emergency department: