Table 1.

The 7-Step Gradual Return-to-Play Postconcussion Protocol^a

Step	Description	Definition
Onset	Onset	Date concussion occurred
1	Cognitive rest	Date athletic trainer counsels or student-athlete initiates cognitive rest
2	Full return to school	Date student-athlete returns to school full time; school adjustments may be provided at this time
3	Light aerobic activity	Date athlete is able to start light aerobic activity without symptoms (stationary bike or timed run) and has completed all of the following: • Medical clearance • Normal results on ImPACTb compared with baseline or norm • Normal results on Balance Error Scoring System compared with baseline • No school adjustments or accommodations being provided • Asymptomatic for at least 24 hours
4	Running and sport-specific drills	Date athlete is able to perform individual strenuous running and sprints and individual noncontact sport-specific drills without symptoms
5	Noncontact drills	Date athlete is able to perform team noncontact and sport-specific drills without symptoms
6	Full-contact practice	Date athlete is able to perform a full day of full-contact practice without symptoms
7	Return to game	Date athlete may participate without limitations and is discharged

^aStep 1 in the 2009 consensus statement⁷ was divided into 2 steps.

^bImPACT Applications, Inc, San Diego, CA.