1. Move forward to the next stage only when symptom free for 24 hours
  2. If symptoms re-appear, regress to previous stages and only participate in activities that you can tolerate
  3. Contact your physician or seek medical help immediately if symptoms worsen

At Home

Stage 1 – Cognitive and Physical Rest
OK if tolerated
  • Short board games
  • Short phone conversations
  • Photography
  • Crafts
Avoid
  • Television
  • Computer/cellphone use
  • School
  • Physical exertion

 

Stage 2a – Light Cognitive Activity
OK if tolerated
  • Easy reading
  • Limited TV
  • Drawing/LEGO/board games
  • Some peer contact
Avoid
  • Computer use
  • School attendance
  • Physical exertion/ sports
  • Work
  • Stair climbing

READY FOR NEXT STAGE? Tolerate 30 min cognitive/ school type activity at home

 

Stage 2b – Light Physical Activity
OK if tolerated
  • School-type work in 30 minute increments
  • Light physical activity
  • Some peer contact
Avoid
  • School attendance
  • Physical exertion/ sports, no work
  • Stair climbing

READY FOR NEXT STAGE? Tolerate up to 1 hour of cognitive activity in 2-3 chunks

 

At School

Stage 3 – Part Time School, Light Load
OK if tolerated
  • Up to 120 mins of cognitive activity in intervals
  • 0.5 days of school/1-2 times a week
  • Some light physical activity
Avoid
  • Music/gym class
  • Tests/exams
  • Homework
  • Heavy physical loads

READY FOR NEXT STAGE? Tolerate school work up to 1-3 hours a day for 0.5-1 day/week

 

Stage 4 – Part Time School, Moderate Load
OK if tolerated
  • Limited testing
  • School work in 4-5 hours/day chunks
  • Homework – up to 30 minutes/day
  • 3-5 days of school/ week
  • Decrease learning accommodation
Avoid
  • Gym/physical exertion
  • Standardized tests/ exams
  • Organized sports

READY FOR NEXT STAGE? Tolerate full-time academic load without worsening symptoms

 

Stage 5 – Nearly Normal Workload
OK if tolerated
  • Nearly normal cognitive activities
  • Routine school work as tolerated
  • Homework – up to 60 minutes/day
  • Minimal learning accommodation
Avoid
  • Gym/physical exertion
  • Standardized tests/ exams
  • Organized sports

READY FOR NEXT STAGE? Tolerate full-time academic load without worsening symptoms

 

Stage 6 – Full Time School
OK if tolerated
  • Normal cognitive activities
  • Routine school work
  • Full curriculum load
  • No learning accommodation
  • Begin Return to Play protocol
Avoid
  • Full participation in sports until medically cleared after Return to Play Protocol
  • Standardized tests/ exams
  • Organized sports

READY FOR NEXT STAGE? Follow Return to Play Protocol

 

Information above has been adapted with permission from Parachute Canada