Research papers that support the present guideline recommendations:

Abbassi, E., & Sirmon-Taylor, B. (2017). Recovery progression and symptom resolution in sport-related mild traumatic brain injury. Brain Injury, 31(12), 1667–1673.

Babcock, L., Kurowski, B. G., Zhang, N., Dexheimer, J. W., Dyas, J., & Wade, S. L. (2017). Adolescents with Mild Traumatic Brain Injury Get SMART: An Analysis of a Novel Web-Based Intervention. Telemedicine and E-Health, 23(7), 600–607.

Babikian, T., McArthur, D., & Asarnow, R. F. (2013). Predictors of 1-month and 1-year neurocognitive functioning from the UCLA longitudinal mild, uncomplicated, pediatric traumatic brain injury study. Journal of the International Neuropsychological Society, 19(2), 145–154.

Bellerose, J., Bernier, A., Beaudoin, C., Gravel, J., & Beauchamp, M. H. (2017). Long-term brain-injury-specific effects following preschool mild TBI: A study of theory of mind. Neuropsychology, 31(3), 229–241.

Brooks, B. L., Mrazik, M., Barlow, K. M., McKay, C. D., Meeuwisse, W. H., & Emery, C. A. (2014). Absence of differences between male and female adolescents with prior sport concussion. Journal of Head Trauma Rehabilitation, 29(3), 257–264.

Brown, N. J., Mannix, R. C., O’Brien, M. J., Gostine, D., Collins, M. W., & Meehan, W. P. (2014). Effect of Cognitive Activity Level on Duration of Post-Concussion Symptoms. Pediatrics, 133(2), e299–e304.

Chrisman, S. P. D., Whitlock, K. B., Somers, E., Burton, M. S., Herring, S. A., Rowhani-Rahbar, A., & Rivara, F. P. (2017). Pilot study of the Sub-Symptom Threshold Exercise Program (SSTEP) for persistent concussion symptoms in youth. NeuroRehabilitation, 40(4), 493–499.

Cordingley, D., Girardin, R., Reimer, K., Ritchie, L., Leiter, J., Russell, K., & Ellis, M. J. (2016). Graded aerobic treadmill testing in pediatric sports-related concussion: safety, clinical use, and patient outcomes. Journal of Neurosurgery: Pediatrics, 18(6), 693–702.

Corwin, D. J., Zonfrillo, M. R., Master, C. L., Arbogast, K. B., Grady, M. F., Robinson, R. L., … Wiebe, D. J. (2014). Characteristics of Prolonged Concussion Recovery in a Pediatric Subspecialty Referral Population. The Journal of Pediatrics, 165(6), 1207–1215.

Covassin, T., Elbin, R. J., Bleecker, A., Lipchik, A., & Kontos, A. P. (2013). Are there differences in neurocognitive function and symptoms between male and female soccer players after concussions? American Journal of Sports Medicine, 41(12), 2890–2895.

Covassin, T., Elbin, R., & Crutcher, B. (2013). The Relationship Between Coping, Neurocognitive Performance, and Concussion Symptoms in High School and Collegiate Athletes. The Sport Psychologist, 27(4), 372–379.

Crowe, L. M., Anderson, V., Barton, S., Babl, F. E., & Catroppa, C. (2014). Verbal ability and language outcome following traumatic brain injury in early childhood. Journal of Head Trauma Rehabilitation, 29(3), 217–223.

Darling, S. R., Leddy, J. J., Baker, J. G., Williams, A. J., Surace, A., Miecznikowski, J. C., & Willer, B. (2014). Evaluation of the Zurich Guidelines and exercise testing for return to play in adolescents following concussion. Clin J Sport Med, 24(2), 128–133.

Darling, S. R., Leddy, J. J., Baker, J. G., Williams, A. J., Surace, A., Miecznikowski, J. C., & Willer, B. (2014). Evaluation of the zurich guidelines and exercise testing for return to play in adolescents following concussion. Clinical Journal of Sport Medicine, 24(2), 128–133.

De Matteo, C., Greenspoon, D., Levac, D., Harper, J. A., & Rubinoff, M. (2014). Evaluating the Nintendo Wii for assessing return to activity readiness in youth with mild traumatic brain injury. Physical and Occupational Therapy in Pediatrics, 34(3), 229–244.

De Matteo, C., Volterman, K. A., Breithaupt, P. G., Claridge, E. A., Adamich, J., & Timmons, B. W. (2015). Exertion testing in youth with mild traumatic brain injury/concussion. Medicine and Science in Sports and Exercise, 47(11), 2283–2290.

DeMatteo, C. A., Randall, S., Lin, C. Y. A., & Claridge, E. A. (2019). What comes first: Return to school or return to activity for youth after concussion? Maybe we don’t have to choose. Frontiers in Neurology, 10(JUL), 1–9.

Dobney, D. M., Grilli, L., Kocilowicz, H., Beaulieu, C., Straub, M., Friedman, D., & Gagnon, I. (2017). Evaluation of an active rehabilitation program for concussion management in children and adolescents. Brain Injury, 31(13–14), 1753–1759.

Dobney, D. M., Grilli, L., Kocilowicz, H., Beaulieu, C., Straub, M., Friedman, D., & Gagnon, I. J. (2018). Is There an Optimal Time to Initiate an Active Rehabilitation Protocol for Concussion Management in Children? A Case Series. Journal of Head Trauma Rehabilitation, 33(3), E11–E17.

Gabbe, B. J., Brooks, C., Demmler, J. C., Macey, S., Hyatt, M. A., & Lyons, R. A. (2014). The association between hospitalisation for childhood head injury and academic performance: Evidence from a population e-cohort study. Journal of Epidemiology and Community Health, 68(5), 466–470.

Gagnon, I., Grilli, L., Friedman, D., & Iverson, G. L. (2016). A pilot study of active rehabilitation for adolescents who are slow to recover from sport-related concussion. Scandinavian Journal of Medicine and Science in Sports, 26(3), 299–306.

Gibson, S., Nigrovic, L. E., O’Brien, M., & Meehan, W. P. (2013). The effect of recommending cognitive rest on recovery from sport-related concussion. Brain Injury, 27(7–8), 839–842.

Grabowski, P., Wilson, J., Walker, A., Enz, D., & Wang, S. (2017). Multimodal impairment-based physical therapy for the treatment of patients with post-concussion syndrome: A retrospective analysis on safety and feasibility. Physical Therapy in Sport, 23, 22–30.

Green, S. L., Keightley, M. L., Lobaugh, N. J., Dawson, D. R., & Mihailidis, A. (2018). Changes in working memory performance in youth following concussion. Brain Injury, 32(2), 182–190.

Grool, A. M., Aglipay, M., Momoli, F., Meehan, W. P., Freedman, S. B., Yeates, K. O., … Zemek, R. (2016). Association Between Early Participation in Physical Activity Following Acute Concussion and Persistent Postconcussive Symptoms in Children and Adolescents. Jama, 316(23), 2504.

Guo, X., Edmed, S. L., & Anderson, V. (2017). Neurocognitive predictors of posttraumatic stress disorder symptoms in children 6 months after traumatic brain injury: A prospective study. Neuropsychology, 31(1), 84–92.

Heyworth, B. E., Carroll, K. M., Rizza, A. J., McInnis, K. C., & Gill, T. J. (2014). Treatment of Concussion in High School Athletes: A Proposed Protocol for Athletic and Academic Return to Activity. Orthopaedic Journal of Sports Medicine, 2(7), 2015.

Howell, D. R., Mannix, R. C., Quinn, B., Taylor, J. A., Tan, C. O., & Meehan, W. P. (2015). Physical Activity Level and Symptom Duration Are Not Associated after Concussion. American Journal of Sports Medicine, 44(4), 1040–1046.

Howell, D., Osternig, L., Van Donkelaar, P., Mayr, U., & Chou, L. S. (2013). Effects of concussion on attention and executive function in adolescents. Medicine and Science in Sports and Exercise, 45(6), 1030–1037.

Kaldoja, M.-L., & Kolk, A. (2015). Does Gender Matter? Differences in Social-Emotional Behavior Among Infants and Toddlers Before and After Mild Traumatic Brain Injury. Journal of Child Neurology, 30(7), 860–867.

Konigs, M., Heij, H. A., van der Sluijs, J. A., Vermeulen, R. J., Goslings, J. C., Luitse, J. S. K., … Oosterlaan, J. (2015). Pediatric Traumatic Brain Injury and Attention Deficit. Pediatrics, 136(3), 534–541.

Kurowski, B. G., Hugentobler, J., Quatman-Yates, C., Taylor, J., Gubanich, P. J., Altaye, M., & Wade, S. L. (2017). Aerobic exercise for adolescents with prolonged symptoms after mild traumatic brain injury: An exploratory randomized clinical trial. Journal of Head Trauma Rehabilitation, 32(2), 79–89.

Lax, I. D., Paniccia, M., Agnihotri, S., Reed, N., Garmaise, E., Azadbakhsh, M., … Keightley, M. (2015). Developmental and gender influences on executive function following concussion in youth hockey players. Brain Injury, 29(12), 1409–1419.

Manikas, V., Babl, F. E., Hearps, S., Dooley, J., & Anderson, V. (2017). Impact of Exercise on Clinical Symptom Report and Neurocognition after Concussion in Children and Adolescents. Journal of Neurotrauma, 34(11), 1932–1938.

McGrath, N., Dinn, W. M., Collins, M. W., Lovell, M. R., Elbin, R. J., & Kontos, A. P. (2013). Post-exertion neurocognitive test failure among student-athletes following concussion. Brain Injury, 27(1), 103–113.

Moser, R. S., Schatz, P., Glenn, M., Kollias, K. E., & Iverson, G. L. (2015). Examining prescribed rest as treatment for adolescents who are slow to recover from concussion. Brain Injury, 29(1), 58–63.

O’Brien, M. J., Howell, D. R., Pepin, M. J., & Meehan, W. P. (2017). Sport-related concussions: Symptom recurrence after return to exercise. Orthopaedic Journal of Sports Medicine, 5(10), 1–6.

Purcell, L. K., Davis, G. A., & Gioia, G. A. (2019). What factors must be considered in “return to school” following concussion and what strategies or accommodations should be followed? A systematic review. British Journal of Sports Medicine, 53(4), 5–18.

Ransom, D. M., Burns, A. R., Youngstrom, E. A., Vaughan, C. G., Sady, M. D., & Gioia, G. A. (2016). Applying an Evidence-Based Assessment Model to Identify Students at Risk for Perceived Academic Problems following Concussion. Journal of the International Neuropsychological Society, 22(10), 1038–1049.

Ransom, D. M., Vaughan, C. G., Pratson, L., Sady, M. D., McGill, C. A., & Gioia, G. A. (2015). Academic Effects of Concussion in Children and Adolescents. Pediatrics, 135(6), 1043–1050.

Russell, K., Hutchison, M. G., Selci, E., Leiter, J., Chateau, D., & Ellis, M. J. (2016). Academic outcomes in high-school students after a concussion: A retrospective population-based analysis. PLoS ONE, 11(10), 1–12.

Russell, K., Selci, E., Black, B., Cochrane, K., & Ellis, M. (2019). Academic outcomes following adolescent sport-related concussion or fracture injury: A prospective cohort study. PLoS ONE, 14(4), 1–14.

Ryan, N. P., Catroppa, C., Beare, R., Coleman, L., Ditchfield, M., Crossley, L., … Anderson, V. A. (2015). Predictors of longitudinal outcome and recovery of pragmatic language and its relation to externalizing behaviour after pediatric traumatic brain injury. Brain and Language, 142, 86–95.

Sarmiento, K., Donnell, Z., Bell, E., & Hoffman, R. (2019). From the CDC: A qualitative study of middle and high school professionals’ experiences and views on concussion: Identifying opportunities to support the return to school process. Journal of Safety Research, 68, 223–229.

Shendell, D. G., Gonzalez, L., Listwan, T. A., Pancella, J., Blackborow, M., & Boyd, J. (2019). Developing and Piloting a School-Based Online Adolescent Student-Athlete Concussion Surveillance System. Journal of School Health, 89(7), 527–535.

Silverberg, N. D., Iverson, G. L., McCrea, M., Apps, J. N., Hammeke, T. A., & Thomas, D. G. (2016). Activity-related symptom exacerbations after pediatric concussion. JAMA Pediatrics, 170(10), 946–953.

Stockbridge, M. D., Doran, A., King, K., & Newman, R. S. (2018). The effects of concussion on rapid picture naming in children. Brain Injury, 32(4), 506–514.

Sufrinko, A. M., Kontos, A. P., Apps, J. N., McCrea, M., Hickey, R. W., Collins, M. W., & Thomas, D. G. (2017). The Effectiveness of Prescribed Rest Depends on Initial Presentation After Concussion. Journal of Pediatrics, 185, 167–172.

Teel, E. F., Marshall, S. W., Shankar, V., McCrea, M., & Guskiewicz, K. M. (2017). Predicting Recovery Patterns After Sport-Related Concussion. Journal of Athletic Training, 52(3), 288–298.

Thomas, D. G., Apps, J. N., Hoffmann, R. G., McCrea, M., & Hammeke, T. (2015). Benefits of Strict Rest After Acute Concussion: A Randomized Controlled Trial. Pediatrics, 135(2), 213–223.

Van Beek, L., Ghesquière, P., Lagae, L., & De Smedt, B. (2015). Mathematical Difficulties and White Matter Abnormalities in Subacute Pediatric Mild Traumatic Brain Injury. Journal of Neurotrauma, 32(20), 1567–1578.

Van Beek, L., Vanderauwera, J., Ghesquière, P., Lagae, L., & De Smedt, B. (2015). Longitudinal changes in mathematical abilities and white matter following paediatric mild traumatic brain injury. Brain Injury, 29(13–14), 1701–1710.

Wasserman, E. B., Bazarian, J. J., Mapstone, M., Block, R., & Van Wijngaarden, E. (2016). Academic dysfunction after a concussion among US high school and college students. American Journal of Public Health, 106(7), 1247–1253.


Research papers not associated with a current recommendation:

Rozbacher, A., Selci, E., Leiter, J., Ellis, M., & Russell, K. (2017). The Effect of Concussion or Mild Traumatic Brain Injury on School Grades, National Examination Scores, and School Attendance: A Systematic Review. Journal of Neurotrauma, 34(14), 2195–2203.

Last update: November 16, 2019