{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:10:21Z","timestamp":1787008221767,"version":"build-2736575974"},"reference-count":62,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Neurotrauma Reports"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:p>Primary care providers can play a crucial role in the clinical management of concussion. However, many providers lack up-to-date information about best practices for rest and return to activity after these injuries. Most research on this topic has been conducted in athletes, and so less is known about how to assist patients with returning to activity in other settings and populations. This article provides a review of best practices for management of progressive return to activity after concussion, with an emphasis on \u201clessons learned\u201d from the Defense and Veterans Brain Injury Center (DVBIC) Progressive Return to Activity (PRA) study, a multi-site longitudinal research project conducted to evaluate concussion management practices and the effectiveness of provider training on DVBIC clinical recommendations (CRs). Provider clinical practices and patient outcomes were examined at three U.S. military treatment facilities before and after providers completed a standardized training on DVBIC PRA CRs. In summary, research findings provide additional support that concussion recovery can be influenced by patients' activity levels after injury. Patients with concussion may experience poorer outcomes if they return to pre-injury levels of activity too rapidly, but they may also be at risk for prolonged symptoms if they fail to increase activity levels over time after an initial period of rest. Additionally, training primary care providers in return to activity guidelines can result in more effective patient education and better clinical outcomes. This knowledge can be used to inform best practices for progressive return to activity in both civilian and military settings.<\/jats:p>","DOI":"10.1089\/neur.2020.0023","type":"journal-article","created":{"date-parts":[[2020,10,29]],"date-time":"2020-10-29T22:13:00Z","timestamp":1604009580000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Best Practices for Progressive Return to Activity after Concussion: Lessons Learned from a Prospective Study of U.S. Military Service Members"],"prefix":"10.1177","volume":"1","author":[{"given":"Mark L.","family":"Ettenhofer","sequence":"first","affiliation":[{"name":"Defense and Veterans Brain Injury Center, Silver Spring, Maryland, USA."},{"name":"Naval Medical Center San Diego, San Diego, California, USA."},{"name":"General Dynamics Information Technology, Fairfax, Virginia, USA."},{"name":"University of California, San Diego, La Jolla, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosemay A.","family":"Remigio-Baker","sequence":"additional","affiliation":[{"name":"Defense and Veterans Brain Injury Center, Silver Spring, Maryland, USA."},{"name":"Naval Hospital Camp Pendleton, Camp Pendleton, California, USA."},{"name":"Henry M. Jackson Foundation, Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason M.","family":"Bailie","sequence":"additional","affiliation":[{"name":"Defense and Veterans Brain Injury Center, Silver Spring, Maryland, USA."},{"name":"General Dynamics Information Technology, Fairfax, Virginia, USA."},{"name":"Naval Hospital Camp Pendleton, Camp Pendleton, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wesley R.","family":"Cole","sequence":"additional","affiliation":[{"name":"Defense and Veterans Brain Injury Center, Silver Spring, Maryland, USA."},{"name":"Womack Army Medical Center, Fort Bragg, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Gregory","sequence":"additional","affiliation":[{"name":"Defense and Veterans Brain Injury Center, Silver Spring, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,10,29]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1080\/16501960410023732"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511435626"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515599634"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/HTR.0000000000000155"},{"key":"e_1_3_5_6_2","unstructured":"Defense and Veterans Brain Injury Center . 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