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R2Play: A simulated sports environment to support return-to-play decision-making following youth concussion

Background. In Ontario, Rowan’s Law (2018) will mandate clinician clearance for young athletes to return-to-play if they experience a concussion. However, clinicians are lacking the tools they need to make these decisions. Right now, we rely on a combination of symptom reporting and single domain assessments (like cardio workouts, or cognitive tasks) to decide whether an athlete is ready to go back to sports. However, sports are a demanding multitask environment that requires balancing physical, emotional, and cognitive demands all at once. 

Using assessments that don’t simulate sports environments means that clinicians could be missing key information to help them decide whether a concussion has resolved. When youth return to sport too soon, they are at risk for poor outcomes like extended recovery or further brain injury. 

Objective and approach. We aim to keep kids safe by building a return-to-play assessment that better simulates sports. The assessment, R2Play, will be a cognitively and physically challenging multi-domain assessment that uses low-cost sensors to help clinicians score and assess athletes. Our researchers at Holland Bloorview Kids Rehabilitation Hospital will collaborate with key stakeholders in youth sports like parents, athletes, coaches, and clinicians to understand what they want and need from the R2Play assessment. Combining their feedback with scientific evidence, our team of engineers, clinicians, and scientists, will build the R2Play assessment. Then, we will continually test and refine our assessment until it meets the needs of stakeholders in practice. 

Impact. The R2Play assessment will be a valuable tool for clinicians and an advancement in the standard of care for young athletes returning to sport after concussion. This improvement will help ensure the safety of athletes, and will allow clinicians, parents, and coaches to have confidence in return-to-play decisions.


Elaine Biddiss, MASc, PhD

Shannon Scratch, PhD, CPsych

Student Researchers

Danielle DuPlessis, BSc, MSc Candidate

Emily Lam, BASc, MSc Candidate

An interdisciplinary project between the PEARL Lab and NOvEL Lab



Attributions: Photo designed by Freepik