• Scott R Darling, John J Leddy, John G Baker, Amy J Williams, Anthony Surace, Jeffrey C Miecznikowski, and Barry Willer.
• *Departments of Orthopaedics; †Nuclear Medicine; ‡Biostatistics; and §Psychiatry, University at Buffalo, Buffalo, New York.
• Clin J Sport Med. 2014 Mar 1; 24 (2): 128-33.

ObjectiveTo evaluate return to play (RTP) and return to classroom outcomes when the Zurich guidelines are combined with a standardized exercise treadmill test [Buffalo Concussion Treadmill Test (BCTT)] and computerized neuropsychological (cNP) testing in adolescent athletes after concussion.DesignRetrospective chart review and follow-up.SettingUniversity Sports Medicine Concussion Clinic.ParticipantsOne hundred seventeen athletes (75% male) with sport concussion ages 13 to 19 years and telephone follow-up of 91 (77.8%) athletes and their parents.InterventionsConcussed athletes who were asymptomatic at rest completed Automated Neuropsychological Assessment Metrics or Immediate Post-concussion Assessment and Cognitive Test cNP testing followed by the BCTT on the same day. Athletes then followed the Zurich consensus guidelines for RTP.Main Outcome MeasuresThe primary outcome measure was the degree of success in RTP, that is, RTP with or without return of concussive symptoms. Secondary outcome measure was return to school with or without symptoms.ResultsAll athletes returned to sport without exacerbation of symptoms. Telephone follow-up revealed that 38.5% experienced new issues upon return to the classroom. Forty-eight percent of athletes had 1 or more cNP subtests below average (ConclusionsThe BCTT in combination with the Zurich consensus guidelines seems to be safe and successful for RTP. There is evidence to suggest that cNP testing performed in athletes who do not have a preinjury baseline test was not related to RTP or problems upon return to school.

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