What criterion must be met to advance to the next stage in return-to-play progression after a concussion?

• A. Clinician clearance
• B. Symptom-free at rest and exertion
• C. Normal ECG
• D. Rest for 48 hours

Answer: (B)

The key idea is that progression through a graded return-to-play protocol depends on the brain no longer producing symptoms when activity is increased. Being symptom-free at rest and with exertion shows the brain has recovered enough to handle higher levels of activity without triggering a setback. That safety check helps prevent re-injury from pushing too soon.

Other options aren’t the deciding factor for advancing. Clinician clearance may be part of a broader protocol but isn’t the direct gate for moving to the next stage. A normal ECG isn’t relevant to concussion recovery or return-to-play criteria, and resting for 48 hours might be part of initial management but does not by itself determine eligibility to progress through the stages.