Code No.: 504.8
STUDENT ACTIVITY CONCUSSION PROCEDURES
The impact of concussions on student’s academic performance can be significant. Anamosa
Community Schools will follow the below cited protocol when dealing with student’s identified
as having or as presenting the characteristics of having a concussion. Student’s not seeking
medical treatment, but presenting the characteristics of having a concussion may be removed
from extra-curricular participation until the identified criteria is met.
Return to participation following a concussion is a medical decision. A non-district employed
licensed medical professional as cited in Iowa Code Section 280.13 C will be required to make
this decision. Per Iowa Code, licensed medical professionals include a physician, a physician’s
assistant, a chiropractor, an advanced registered nurse practitioner, a nurse, a physical therapist
or a licensed athletic trainer.
The protocol below will be used to determine when return to participation is appropriate:
Return to participation will be granted when the following two criteria are met.
Asymptomatic at rest, and with exertion (including mental exertion in school),
AND have written clearance from a licensed medical professional is identified by
Iowa Code Section 280.13C and cited above.
An appropriate health care professional, or their designee, should closely supervise this
progression. A district health care professional may be part of this supervision.
Progression to return is individualized and should be determined on a case-by-case basis. Factors
that may affect the rate of progression include: previous history of concussion, duration and type
of symptoms, age of the student, and sport/activity in which the student participates. A student
with a history of concussion, one who has had an extended duration of symptoms, or one who is
participating in a collision or contact sport may progress more slowly as determined by an
appropriate health care professional, or their designee.
This protocol is based on the Stepwise Process and is as follows:
1. Complete physical and cognitive rest. No exertion activity until asymptomatic. This
may include staying home from school or limiting school hours (and studying) for
several days. Activities requiring concentration and attention may worsen
symptoms and delay recovery.
2. Return to school full-time.
3. Low impact, light aerobic exercise. This step should not begin until the student is no
longer having concussion symptoms and is cleared by the treating primary healthcare
provider or concussion specialist for further activity. At this point the student
may begin brisk walking, light jogging, swimming or riding an exercise bike at less
than 70% maximum performance heart rate. No weight or resistance training.
4. Basic exercise, such as running in the gym or on the field. No helmet or other
5. Non-contact, sport-specific training drills (dribbling, ball handling, batting, fielding,
running drills, etc.) in full equipment. Weight-training can begin.
6. Following medical clearance as cited above, full contact practice or training.
7. Normal competition in a contest.
NOTE: Generally, each step should take a minimum of 24 hours. If post-concussion symptoms
occur at ANY step, the student must stop the activity and their health care provider should be
contacted. If any post- concussion symptoms occur during this process the student should drop
back to the previous asymptomatic level and begin the progression again after an additional 24-
hour period of rest has taken place.
References: “Suggested Guidelines for Management of Concussion in Sports,” NFHS Sports
Medicine Advisory Committee 2009; “Consensus State on Concussion in Sport 3rd International
Conference in Sport Held in Zurich, November 2008,” Clinical Journal of Sports Medicine,
Volume 19, Number 3, May 2009.
Code No.: 504.8