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J Pediatr Surg. 2014 Feb;49(2):341-4. doi: 10.1016/j.jpedsurg.2013.10.016. Epub 2013 Oct 23.

A community return-to-play mTBI clinic: results of a pilot program and survey of high school athletes.

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Santa Barbara Cottage Hospital, Rehabilitation and Pediatric Trauma Services, Santa Barbara, CA, USA. Electronic address:
Santa Barbara Cottage Hospital, Rehabilitation and Pediatric Trauma Services, Santa Barbara, CA, USA.



High school athletes who sustain a mild traumatic brain injury (mTBI) or concussion are required to be removed from play until clearance by a provider. A regional pediatric trauma center offered an mTBI clinic to evaluate students for return to play (RTP).


An mTBI clinic was developed in collaboration with a high school district containing three schools. This program evaluated students suffering from sports-related head trauma, specifically football injuries. Community mTBI education was performed, a standardized RTP algorithm was developed, and a postseason survey was administered to football players.


Twenty-eight students playing football were seen by the mTBI clinic. The average time until RTP for clinic patients was 16.9 days. Four hundred five players were surveyed. Of players responding to the survey, 40 (15%) reported sustaining an mTBI during the football season. Of those sustaining an mTBI, 9 (22.5%) did not report their symptoms.


Although the mTBI rate is similar to reported rates, the unreported mTBI episodes were lower (22.5%) than previously published self-reported mTBI rates. The RTP algorithm was successful in returning athletes in 16.9 days. The algorithm and data can be utilized by other organizations in establishment of an mTBI clinic and RTP program.


Adolescent; Athlete; Concussion; High school; Mild traumatic brain injury; Pediatric; RTP; Return to play; Underreported concussion; Underreported mTBI; mTBI; mTBI clinic; mTBI legislation

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