Concussion Treatment: Return to Learn

Tricia Hayton, Registered Physiotherapist
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Concussion is a hot topic in schools.  Thousands of students from Kindergarten to university suffer concussions each year. This can be from a fall, a car accident or from sports.   Following a concussion, cognitive and physical rest is prescribed.  Recent studies have shown us that this rest should be limited to approximately 24 to 48 hours.   After that amount of time, sub-symptomatic activities can actually be beneficial in restoring brain function and reducing symptoms. 

We often hear about athletes returning to sports.   Our professional athletes will have “red jersey” practices where they get back to their technical and fitness skills but refrain from contact.  When tolerated, they begin contact and eventually return to the games they love.

But how does a student return to school?  What are the steps?

There are some simple guidelines:

1. For student athletes, return to school should precede any attempt to return to sport

2.  Like return to sport, return to learn should be coordinated by a trained medical professional.  Ideally, a team of professionals including therapists and doctors is best.

3. There are four stages to return to learn.  A student progresses through each stage when the current demand is met without any increase in symptoms for a minimum of 24 hours.

4. If symptoms increase as they progress, they are to return to the previous level for a minimum of 24 hours. ​

The stages of return to learn include:

1. Light cognitive activity: this includes reading and games done at home

2. School type work/light physical activity:  this is work done that is similar to the demands of school, but in 30-minute blocks.   Some light activity, such as going for a walk, is encouraged.

3. Part time school:  this can be divided into light load and moderate load, indicating the time spent in school, including hours per day or days per week

4. Nearly normal workload progressing to full time demands: Time and homework are increased as tolerated.   At this point, accommodations are often needed as only certain aspects will increase symptoms (ie: reduced computer time).  Physical Education class is not included as it should be increased during the return to sport phase. 

For more information please visit: 
http://horizon.parachutecanada.org/wp-content/uploads/2017/06/RTL-Parachute-2018May.pdf.  
 
The staff at Physio Sport Med work as a team to help guide you through these challenges.  If you think that we could help you or someone you love, please give us a call.  ​