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Is the content and duration of the graduated return to play protocol after concussion demanding enough? A challenge for Berlin 2016
  1. Simon Kemp1,
  2. Jon Patricios2,3,4,
  3. Martin Raftery5
  1. 1 Rugby Football Union, London, UK
  2. 2 Sports Concussion South Africa, Johannesburg, South Africa
  3. 3 Faculty of Health Sciences, The Section of Sports Medicine, University of Pretoria, Pretoria, South Africa
  4. 4 Faculty of Health Sciences, The Department of Emergency Medicine, University of the Witwatersrand, Johannesburg, South Africa
  5. 5 World Rugby, Dublin, Ireland
  1. Correspondence to Dr Simon Kemp, Rugby Football Union, Twickenham Stadium, 200 Whitton Road, Twickenham, London TW2 7BA, UK; E:simonkemp@rfu.com

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Introduction

Determining the appropriate starting point and duration of the return-to-play (RTP) process after injury is fundamental to clinical sports medicine. The most commonly cited RTP framework after concussion is outlined as part of all international concussion consensus statements. This framework is a key element of concussion management across all levels of sport and provides a ‘cornerstone’ of current education initiatives. In Rugby Union, RTP guidelines last underwent a major update by World Rugby, the International Federation, in 2011, and are consistent with international concussion consensus.

There is a limited evidence base informing the content and duration of the graduated return to play (GRTP). Specifically, the evidence evaluating the effect, optimal amount and type of rest is sparse. Moreover, current RTP guidelines for children and adolescents are based on those of adults.

While research concerning a range of clinical outcomes following concussive injury in sport continues to develop, until recently, little has been known about the consequences …

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