Table 2.

Summary of Recommendations for Management of Concussion in Sport from Current Consensus Documents.

	Acute Tx	Medications	Behavioral	Academic Accommodations	RTP protocol	Other therapies
American Academy of Neurology (2013)²¹	No same day RTP	No evidence based intervention for concussions	Cognitive restructuring to prevent PCS	Individualized grade plans for cognitive activity	Supervised, graded exertion program, asymptomatic off medication	-
American Medical Society for Sports Medicine (2013)²³	No same day RTP; appropriate disposition to home, ER, etc; frequent awakenings no longer recommended	Acetaminophen	Relative physical and cognitive rest; in the early stages, athlete should not engage in physical or cognitive activities that result in an increase in symptoms; Dim, quiet environment	No standardized guidelines for returning athletes to school; if symptoms develop, athlete may need reduced workload, extended test taking, shortened school day	Individualized, gradual, and progressive; normal cognitive/balance evaluation,	-
American Academy of Pediatrics (2010)²²	No same day RTP; athlete should be monitored for several hours to determine if emergency department is warranted	No evidence-based research for medications	Discourage activities that require concentration and attention; withhold physical activity until asymptomatic	Cognitive rest, including absence from school, shortening school day, reduction of workload, allowance of more time	Graded return to play	Assessment of mental health problems; Patients with PCS may benefit from exercise training
International Consensus Statement (2013)¹⁷	No same day RTP; Physical and cognitive rest until symptoms resolve	Treatment for specific symptoms	Gradual return to school and social activities, before sport	-	Graded RTP	Low level exercise for those slow to recover; multidisciplinary management for “difficult” patients
National Athletic Trainers’ Association (2014)²⁰	No same day RTP; do not awaken patient unless prolonged LOC/amnesia; no aspirin	Over-the-counter, as needed for symptoms	Avoid physical activity and limit cognitive activity to not exacerbate concussion symptoms; ADLs that do not exacerbate symptoms may be beneficial and allowed	Temporary accommodations should be allowed	Should not begin until patient no longer reports symptoms, has normal clinical examination, and normal neurocognitive functioning/motor; Exercise Progression	-
National Collegiate Athletic Association (2013)²⁴	No same day RTP; Provide instructions; athletes should not be left alone; avoid alcohol, aspirin; determine if imaging is needed	-	Physical and cognitive rest until the acute symptoms resolve	Some athletes may require academic accommodations, such as reduced workload, extended test-taking time, das off or shortened day	Supervised, graded program of exertion	Tx for postconcussion syndrome (PCS) and depression is different than tx for acute concussion
Team Physician Consensus Statement-ACSM (2011)²⁵	No same day RTP; determine disposition; communicate with parents/ coaches, etc.	-		Team physicians should facilitate academic accommodations	No medications that mask symptoms; NP testing normal (if performed); progressive aerobic and resistance exercise training	-