Parachute’s Protocol for AT HOME

RETURN TO LEARN Stage Cognitive & physical rest Stage Light cognitive Stage Light physical
After a Concussion 1 for first 24-48 hours
2a activity
60
2b activity

1. Move forward to the next 45 15

stage only when Symptom- 30

free for 24 hours

OK if tolerated Not OK OK if tolerated Not OK OK if tolerated Not OK
2. If symptoms re-appear, ✔ Short board games ✘ No TV ✔ Easy reading ✘ Avoid computer use ✔ School-type work in ✘ No school attendance
regress to previous stages ✔ Short phone ✘ No computer/ ✔ Limited TV ✘ No school attendance 30 minute increments ✘ No physical exertion/
conversations cellphone use ✔ Drawing/LEGO/board ✘ No physical exertion/ ✔ Light physical activity sports
and only participate in ✔ Photography ✘ No reading games sports ✔ Some peer contact
 ✘ No work
activities that you can ✔ Crafts
 ✘ No school ✔ Some peer contact
 ✘ No work ✘ No stair climbing
tolerate ✘ No physical exertion/
stair climbing
✘ No stair climbing

✘ No organized sports
3. Contact your physician or
seek medical help READY READY READY
Symptom-free at least 24 hrs. Tolerate 30 min cognitive/ Tolerate up to 1 hour of
immediately if symptoms FOR
NEXT
FOR
NEXT
FOR
NEXT
between each stage school type activity at home cognitive activity in 2-3 chunks
worsen STAGE? STAGE? STAGE?

AT SCHOOL
Stage Part time school Stage Part time school Stage Nearly normal Stage Full time
Light load Moderate load workload
3 4 5 6 EXAM
293 X 178
= ? 1.
573
2.

3.

OK if tolerated Not OK OK if tolerated Not OK OK if tolerated Not OK OK if tolerated Not OK

✔ Up to 120 mins of ✘ Avoid music/gym ✔ Limited testing ✘ No gym/physical ✔ Nearly normal ✘ No gym/physical ✔ Normal cognitive ✘ No full participation
cognitive activity in class ✔ School work in 4-5 exertion cognitive activities exertion activities in sports until
intervals ✘ No tests/exams hours/day chunks ✘ No standardized tests/ ✔ Routine school work ✘ No standardized tests/ ✔ Routine school work medically cleared
✔ 0.5 days of school/1-2 exams as tolerated exams after Return to Play
✘ No homework ✔ Homework – up to 30 ✔ Full curriculum load
times a week protocol
✘ No heavy physical minutes/day ✘ No organized sports ✔ Homework – up to 60 ✘ No organized sports ✔ No learning
✔ Some light physical loads (e.g. backpack) ✔ 3-5 days of school/ minutes/day accommodation
activity
 week ✔ Minimal learning ✔ Begin Return to Play
✔ Decrease learning accommodation
 protocol

accommodation

READY READY READY READY
FOR Tolerate school work up to 1-3 FOR Tolerate 4-5 hours/day in FOR Tolerate full-time academic load FOR
NEXT NEXT NEXT NEXT Follow Return to Sport protocol
hours a day for 0.5-1 day/week chunks for 2-4 days/week STAGE?
without worsening symptoms STAGE?
STAGE? STAGE?

Adapted from: • 2016 Berlin Consensus Statement on Concussion in Sport • CATT’s Return To Learn Communication Tool • Dr.Mike Evan’s Concussion management and Return To Learn video  • McMasterU’s CanChild Return to School Guideline v1.2 2017-06