Graduated RTP Protocol (After a Sport-Related Concussion)30

Rehabilitation StageFunctional Exercise at Each Stage of RehabilitationObjective of Each Stage
1. No activityComplete physical and cognitive restRecovery
2. Light aerobic exerciseWalking, swimming, or stationary cycling, keeping intensity at <70% of MPHR; no resistance trainingIncrease HR
3. Sport-specific exerciseSkating drills in hockey, running drills in soccer; no head impactAdd movement
4. Noncontact training drillsProgression to more complex training drills (eg, passing drills in football and ice hockey); may start progressive resistance trainingExercise, coordination, and cognitive load
5. Full-contact practiceAfter medical clearance, participate in normal training activitiesRestore confidence and assess functional skills by coaching staff
6. RTPNormal game play
  • HR indicates heart rate; MPHR, maximum permitted heart rate.