Rehabilitation of an Adolescent Equestrian Athlete With a History of Multiple Concussions: A Case Report Describing an Adapted Return-to-Sport Protocol.

This is a single case report, so it cannot show that the protocol works for other adolescent athletes with multiple concussions. There was no long-term follow-up after return to competition. The paper did not report the quality of her riding performance after return. The symptom scale was computerized at baseline and written at follow-up, so the scores are not a direct like-for-like comparison. The initial physical therapy screen was chosen by the therapist's judgment, and the paper does not say it was the best way to decide who needs physical therapy. Cognition was assessed by the neuropsychologist, not screened during the physical therapy evaluation. Cervical segmental mobility and scapular mobility were not assessed at the initial visit. The deep neck flexor endurance improvement did not exceed the smallest change considered real for that test. The smallest change considered real for cervical joint position error testing was not established.

Do not read this as evidence that an adapted riding protocol helps adolescents with multiple concussions. It is a single case report with no comparison group, no long-term follow-up, and no measure of riding performance after return.