Evaluating the Need for Return-to-Learn Concussion Protocols in High School Student-Athletes: An Integrative Review

Over a million high school students are estimated to sustain at least one sports-related concussion annually. Unfortunately, over a third of these student-athletes suffer from post-concussion syndrome, which leads to the question of whether student-athletes are allowed proper time to heal after a concussion or if more can be done to optimize concussion recovery. Proper and optimal recovery post-concussion encompasses both physical and cognitive rest. While concussion management has traditionally focused on the physical aspects of recovery, emphasis has shifted to the cognitive impacts of concussions. There is literature to support that cognitive rest is vitally important, if not equally important, as physical rest after a concussion. Cognitive rest is essential for healing the brain and speeding up recovery post-concussion, while increased cognitive activity post-concussion is associated with longer recovery. Return-to-learn protocols and methodical reintroductions of students into the academic setting are equally vital to allow the brain to recover from sports-related concussions as physical rest and return-to-play protocols. This review’s key focus and purpose is to assess the literature to support suggestions for practice change that involves a mandatory, structured return-to-learn concussion protocol