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Rest and return-to-sport recommendations following sport-related concussion (PEDro synthesis)
  1. Arun Prasad Balasundaram1,
  2. Anthony G Schneiders2,
  3. S John Sullivan3
  1. 1 Department of Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway
  2. 2 School of Human, Health and Social Sciences, Central Queensland University, Branyan, Queensland, Australia
  3. 3 Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
  1. Correspondence to Dr Arun Prasad Balasundaram, Department of Health Sciences, Institute of Health and Society, University of Oslo, Oslo 0315, Norway; a.p.balasundaram{at}

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McLeod TC, Lewis JH, Whelihan K, Bacon CE. Rest and return to activity after sport-related concussion: a systematic review of the literature. J Athl Train 2017; 52: 262–287.


The international Concussion in Sport group consensus statement advocates rest (physical and cognitive) until the resolution of symptoms following sport-related concussion. It also recommends that athletes follow a graduated stepwise progressive protocol to safely return-to-sport (RTS).1 There is currently insufficient evidence1 for implementation of ‘Rest’ and/or ‘Graduated RTS protocol’ for concussion management, nor precise evidence-informed guidelines in terms of timing, quantity and duration for these interventions.


The aim of the systematic review was to synthesise the literature related to rest and RTS/activity recommendations following sport-related concussion.

Searches and inclusion criteria

The articles were retrieved using the search terms such as brain concussion, mild traumatic brain injury, physical and cognitive rest and return-to-activity. The databases were explored from the time of inception until October 2015, and these included the Cochrane Central Register of Controlled Trials, CINAHL, SPORTDiscus, Educational Resources Information …

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  • Contributors APB selected the systematic review and wrote the initial draft of the manuscript. APB, AGS and SJS carried out the critical appraisal of the article, revised drafts and approved the final version of the manuscript.

  • Funding APB is funded by the ’European Union Seventh Framework Programme (FP7-PEOPLE-2013-COFUND) under grant agreement n° 609020 - Scientia Fellows' for the postdoctoral research fellowship programme.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.