Pilot survey regarding “the green folder” – an educator-designed secondary school return to learn protocol after a sport-related concussion

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ObjectiveTo demonstrate whether a user-centred (teacher accepted and student focused) return to learn (RTL) protocol after a sport-related concussion (SRC)has an efficacious role.DesignProspective pilot survey.SettingFour sport medicine clinics in Ontario, Canada.ParticipantsTwenty-eight collegiate athletes (21 males and 7 females: age=20.2 ± 1.7 years, height=182.2 ± 11.9 cm, mass=90.3 ± 24.2 kg) without history of: headaches or migraines, substances/alcohol abuse, and/or psychiatric conditions.InterventionNineSRC students from one (index) school who used the new protocol and a control group (11 SRC students) from other schools, who did not use the new protocol,completed a web-based survey.Outcome measuresPrimary outcome measures include student perception of school support during their SRC RTL.Main resultsTwenty surveys were completed from an eligible 52 students (38.5%).Among students who received the Green Folder at the index school, 71.4% either strongly or mostly agreed thatsuch an RTL protocol could shorten the duration of SRC symptoms. At that school, 100% strongly or mostly agreed (versus 14.3% from the other schools) that the school was very helpful advising about the RTL steps and when they should return to school. 85.7% of students at the index school versus 28.6% from other schools, strongly or mostly agree that the school staff fully understands RTL strategies after SRC.ConclusionsThe “Green Folder” incorporating RTL steps and a daily class-by-class accommodation sign off by a guidance counsellor, appears to have perceived efficacy for SRC students. Further research will determine whether such a user-centred RTL protocol results in a more efficacious implementation of expert recommendations about concussion management, worthy of widespread dissemination.Competing interestsNone.

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