FAQ

If my child sustains a head injury, what should I do?
What does “cognitive rest” mean?
What are the “Return To School” guidelines?
What is the “Five Stages Return To Play” evaluation?
What is post-concussive syndrome and second impact syndrome?
What is the ImPACT test?
How old do you have to be to take the ImPACT test?
Does HeadZone do on-site ImPACT baselines for teams?
Is there Concussion Awareness Training available for students?
Why do some students have to repeat the ImPACT test?

If my child sustains a head injury, what should I do?

If you believe your child is showing unstable symptoms (including, but not limited to, vomiting, severe or progressive headache or dizziness, vision problems, and/or amnesia) call 911 for transport to and evaluation in the nearest hospital emergency department.

If your child is stable but you suspect a concussion, you may make an appointment with a Concussion Care Specialist by calling 203-538-5400.

Concussion Management

What does “cognitive rest” mean?

According to the CDC, rest and careful management of physical and cognitive exertion are the keys to recovery. Cognitive activity includes heavy concentration or focus, visual stress, memory, reasoning, reading or writing (e.g., texting, television, video games, computer use, homework, classwork, job-related activity).

Until a full recovery is achieved, your child or teen may need the following adjustments to home activities:

  • Limitation of television, texting, computers, video games
  • Avoidance of noisy and/or visually stimulating environments (movie theaters, malls, restaurants, grocery stores, audience participation of on-field sports, etc.)

The treating physician will tailor your child or teen’s cognitive rest guidelines according to their exam.

What are the “Return To School” guidelines?

Once the physician determines that it is safe for your child or teen to resume academic activities, any of the following adjustments may be recommended based on the patient’s exam:

  • Shortened day
  • Shortened classes or frequent rest breaks
  • Reduced homework load
  • Extended time to complete coursework
  • No classroom or standardized testing
  • No timed tests
  • Avoidance of Smart Board or computer lab
  • Avoidance of noisy environments (lunchroom, group
    passage in halls, bus transportation)
  • Modification of physical exertion (stairs, gym,
    sports)

What is the “Five Stages Return To Play” evaluation?

When your child or teen is asymptomatic at rest and during academic activities, the physician will recommend a supervised “Five Stages Return to Play” evaluation as follows:

“Return To Play” Protocol
Day 1: LIGHT AEROBIC EXERCISE for 20-30 minutes (goal: increase HR): low stimulus environment, no impact activities, limit head movement/position change, limit concentration activities
  • Light aerobic conditioning (treadmill or surface walking at rate 2.5 mi/h; stationary bike) x 20-30 min
  • Sub-max strengthening
  • ROM/stretching
  • Very low level balance activitiesDATE COMPLETED:___________
Day 2: MODERATE AEROBIC EXERCISE for 20-30 minutes (goal: increase HR): OK to perform in gym areas, use various exercise equipment, allow some positional changes and head movement, low level concentration activities
  • Moderate aerobic conditioning (dribble/shoot, soccer footwork, jogging , swimming) x 20-30 min
  • Light weight strength exercise
  • Stretching (active stretching initiated)
  • Low level balance activitiesDATE COMPLETED:___________
Day 3: SPORT-SPECIFIC EXERCISE for 20-30 minutes (goal: add movement): any environment OK for exercise (indoor/outdoor), integrate strength, conditioning and balance proprioceptive exercise, incorporate concentration challenges 
  • Moderately aggressive aerobic exercise (runningskating, cycling) x 20-30 min
  • Active stretching exercise
  • Challenging proprio-balance activities
  • No contact, no head impact activitiesDATE COMPLETED:___________
Day 4: SPORTS-SPECIFIC PRACTICE DRILLS (goal: add coordination, cognitive load): continue to avoid contact activity, resume aggressive training in all environments 
  • Non-contact physical training (passing, running, and skating drills)
  • Progressive strength and resistance training
  • Impact activities, plyometricsDATE COMPLETED:___________

 

Day 5: FULL CONTACT PRACTICE (no competitive games)

 

DATE COMPLETED:___________
Day 6: PHYSICIAN RE-EVALUATION: Please refer the athlete to our office for a follow-up exam and a post-exercise ImPACT test to determine readiness for contact sports

 

  • REPEAT EXAM BY PHYSICIAN AND POST-RTP IMPACT TEST(DATE OF APPOINTMENT:___________)

If headaches, dizziness, or other symptoms occur during any step, the activity needs to be stopped. The athlete should then wait 24 hours and start at the previous level again.

What is post-concussive syndrome and second impact syndrome?

Head injuries take time to heal. Often, however, concussion in children goes unrecognized. Another blow to the head while the initial concussion is healing can occasionally result in fatal brain swelling — a condition known as second impact syndrome. A young athlete who sustains a concussion is also at risk of developing post-concussion syndrome, which is characterized by persistent concussion symptoms such as headaches, dizziness, irritability and depression. Post-concussion syndrome can last for weeks to months after the injury.

ImPACT Test

What is the ImPACT test?

ImPACT, developed by doctors at the University of Pittsburgh Medical Center (UPMC) Sports Medicine Concussion Program, has proven to be a useful tool in measuring the severity and effects of concussion and determining when it is safe for concussed athletes or individuals to return to sports or activity. With ImPACT, the athlete or individual takes a pre-season or pre-activity 20-minute test on a computer that measures brain processing such as speed, memory and visual motor skills. The individual’s baseline data are stored in a computer file. Should the individual ever experience a concussion, he or she will take the ImPACT following the injury. Post-concussion data are then compared to baseline data to help determine the severity and effects of the injury. The data help determine when the athlete’s neurocognitive brain function has returned to baseline scores when it is safe for the athlete or individual to return to sports or activity.

How old do you have to be to take the ImPACT test?

ImPACT testing is now available for ages five years and older. The ImPACT is for ages 12 to 59, and the ImPACT Pediatric is for ages 5-11.

Does HeadZone do on-site ImPACT baselines for teams?

Yes, please see our Teams & Coaches page.

Is there Concussion Awareness Training available for students?

Why do some students have to repeat the ImPACT test?

Please see our document on Repeating the ImPACT Test.

 

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