Not associated with structural or permanent brain injury and are non-epileptic.
All Ix (including EEG, CT and MRI) are normal.
No further treatment needed.
Can return to sport after 3 symptomatic weeks.
Graduated return to Play (GRTP) - IRFU
Players can only move on to the next stage once they have been symptom free during the full period of each stage.
Objective of stage
U6 - U20s
1. No activity
Complete physical and mental rest without symptoms
2. Light areobic exercise
Walking swimming etc. Intensity <70% max HR (Max predicted HR = 220-Age)
↑ heart rate
3. Rugby specific exercise
Running drills. No impact.
4. Non-contact training drills
Progression to more complex drills e.g. passing. May start resistance training.
Exercise, coordinationa and mental load
5. Following medical clearance, full contact practice
May participate in normal training activities
Restore confidence and assess functional skills by coaching staff
6. After 24hrs, return to play
Sports related concussion in children / adolescents
Girls have higher concussion rates than boys do in similar sports.
LOC is uncommon. If longer than 30 sec, it may indicate more significant intracranial injury.
Concussion can cause symptoms that interfere with school, social & family relationships, and participation in sports.
The signs and symptoms of a concussion typically resolve in 7 to 10 days in the majority of cases.
Cognitive and physical rest is the mainstay of management after diagnosis.
Imaging results are usually normal.
Neuropsychological testing is a helpful tool in the management of concussion.
Return to sport should be accomplished by using a progressive exercise program while evaluating for any return of signs or symptoms (rather than rigidly adhering to specific time intervals).
Athletes with concussion should rest, both physically and cognitively, until their symptoms have resolved both at rest and with exertion. Teachers and school administrators should work with students to modify workloads to avoid exacerbation of symptoms.
No patient (any age) should ever return to play while symptomatic at rest or with exertion.
Athletes also should not be returned to play on the same day of the concussion, even if they become asymptomatic.