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Concussion Care Pathway

Date of last update: May, 2024



Clinical Cornerstone: In every patient encounter, the essence of ongoing monitoring lies in its adaptive nature, continuously aligning and realigning the treatment plan with the patient’s evolving goals and feedback. This process is not just about tracking progress but ensuring that the care trajectory consistently meets the patient’s needs and objectives. It facilitates a patient-centric, goal-oriented approach throughout the care journey, including discharge and post-discharge phases, making the care pathway effective and personally meaningful.

  • Assess: Engage the patient in a conversation to assess their health status and case progression at each encounter.

  • Adjust the Treatment Plan: Regularly update the treatment plan based on patient feedback, outcome measures, and clinical judgment. Utilize techniques like Brief Action Planning to support self-management and promote regular movement and engagement in normal activities, including work.

  • Additional Interventions or Referrals: Based on patient feedback and progress.

  • Align with Patient Goals: Regularly revisit patient's initial goals that were set during the first visit. Discuss progress towards these goals and address any barriers encountered. Adjust goals as necessary to reflect patient’s current needs and preferences.

  • Criteria for Discharge:

    • Establish clear criteria for discharge, which may include achieving specific milestones, reaching a plateau in progress, or fulfilling the patient's initial goals.

    • Discuss post-discharge plans, including self-management strategies, potential follow-ups, and strategies to prevent recurrence.

  • Monitor: the case progression with periodic reassessments and repeat outcome measures.

Conduct patient assessment

Red flags or Orange flags present

Red flags or Orange flags present

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Refer to appropriate emergency or healthcare provider



Acute mTBI

  • Structured patient education

  • Self Care

  • Return to work / school

  • Return to driving

  • Return to sport / activity

Persistent mTBI

  • Monitoring and Reassessment

  • Tailored clinical management of symptoms:

    • Headache
    • Neck Pain
    • Sleep Disturbance
    • Fatigue
    • Emotional / Behavioural
    • Cognitive Disorders
    • Vestibular Disorders

Differential Diagnosis






(Align with patient goals, Criteria for discharge)

Major symptom/sign change

Goals not achieved





Adjust treatment and management plan or refer

References or links to primary sources

  • Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. CDC Heads Up [Internet]. CDC February 2022. Available from:

  • David L. MacIntosh Sports Medicine Clinic, University of Toronto. Post-Concussion Return to Activity Guidelines. EMPWR Our Toolkit [Internet]. EMPWR Foundation 2019. Available from:


Contact information for further inquiries or feedback


These care pathways are intended to provide information to practitioners who provide care to people with musculoskeletal conditions. The care pathways on this website are 'living' documents, reflecting the state of clinical practice and research evidence to our best knowledge at the time of development. As knowledge and healthcare practices evolve, these pathways may be updated to ensure they remain current and evidence driven. These pathways are not intended to replace advice from a qualified healthcare provider.

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