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This study aims to update CanChild\u2019s 2015 RTA and RTS protocols, on the basis of empirical data and feedback collected from our recently completed prospective cohort study, focusing on concussed children and their caregivers; systematic review of evidence published since 2015; and consultation with concussion management experts. The new protocols highlight differences from the earlier versions, mainly, (1) symptom strata to allow quicker progression for those who recover most quickly; (2) a shortened rest period (24-48 hours) accompanied by symptom-guided activity; (3) the recommendation that children progress through the stages before they are symptom free, if symptoms have decreased and do not worsen with activity; (4) specific activity suggestions at each stage of the RTA protocol; (5) recommendations for the amount of time to spend per stage; and (6) integration of RTS and RTA.<\/jats:p>","DOI":"10.1177\/0009922819879457","type":"journal-article","created":{"date-parts":[[2019,10,18]],"date-time":"2019-10-18T06:02:56Z","timestamp":1571378576000},"page":"5-20","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Concussion Management for Children Has Changed: New Pediatric Protocols Using the Latest Evidence"],"prefix":"10.1177","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0053-2379","authenticated-orcid":false,"given":"Carol","family":"DeMatteo","sequence":"first","affiliation":[{"name":"School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada"},{"name":"CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Randall","sequence":"additional","affiliation":[{"name":"CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katie","family":"Falla","sequence":"additional","affiliation":[{"name":"CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chia-Yu","family":"Lin","sequence":"additional","affiliation":[{"name":"CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada"},{"name":"ARiEAL, Centre for Advanced Research in Experimental & Applied Linguistics, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucy","family":"Giglia","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada"},{"name":"Department of Pediatrics, McMaster Children\u2019s Hospital, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael F.","family":"Mazurek","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada"},{"name":"Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Koelink","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Department of Pediatrics, McMaster University Medical Centre and McMaster University, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,10,18]]},"reference":[{"key":"bibr1-0009922819879457","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000000682"},{"key":"bibr2-0009922819879457","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2017-097699"},{"key":"bibr3-0009922819879457","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2015.04.003"},{"key":"bibr4-0009922819879457","doi-asserted-by":"publisher","DOI":"10.1177\/0009922814567305"},{"key":"bibr5-0009922819879457","doi-asserted-by":"publisher","DOI":"10.1177\/0009922814558256"},{"key":"bibr6-0009922819879457","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2016-097415"},{"key":"bibr7-0009922819879457","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2012-092132"},{"key":"bibr8-0009922819879457","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2011.07.015"},{"key":"bibr9-0009922819879457","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-3434"},{"key":"bibr10-0009922819879457","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2010.12.006"},{"key":"bibr11-0009922819879457","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2019.00792"},{"key":"bibr12-0009922819879457","doi-asserted-by":"publisher","DOI":"10.3109\/09638288.2014.952452"},{"key":"bibr13-0009922819879457","unstructured":"National Institute for Health and Care Excellence. 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