Symptom free return to sport following supervised exercise and a return to play progression

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ObjectiveTo determine if completion of a symptom free return to play progression (RTPP) was associated with a symptom free return to sport. A secondary analysis investigated symptom free return to sports participation following supervised exercise.BackgroundThe current consensus statement on concussion in sport recommends a graded return-to-sport strategy but there is limited data on the utility of this approach.Methods200 sequential clinic patients with physician-diagnosed concussion sustained during sport participation were contacted by phone following completion of care from a University-associated Sports Neurology clinic. A survey about their success in returning to their sport was administered. Standardized data elements were extracted from the medical records and analyzed. The study was approved by the university of Michigan Institutional Review Board.ResultsThe survey was completed on 61 (31%) patients. Of these, 57 (93%) returned to sport participation without symptom reoccurrence. Of those who returned to sport 41 (80%) returned to sport without symptom reoccurrence within 2 weeks of completed clinical care. 53 (87%) completed a RTPP and 49 (92%) of those completing a RTPP returned to sport without symptom reoccurrence. Completing a RTPP, compared to those not completing a RTPP, was significantly associated with return to sport participation without symptom reoccurrence (p = 0.0000001). Of those surveyed, 32 (52%) underwent supervised exercise (SE) as part of their clinical care. Completing SE, as compared to those not undergoing SE, was significantly associated with return to sport participation without symptom reoccurrence (p = 0.017).ConclusionsOur results support recommendations for utilizing graded return-to-sport strategy demonstrating that 92% of those completing a RTPP successfully returned to sport. Our data also suggest that completion of SE was a predictor of symptom free return to sport and can be incorporated in to return to play decision making.