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The nurse practitioners in the neurotrauma clinic will let you know when you can begin monitored progression of physical activity. At that time, they may refer you to physical therapy.

Why Am I Being Referred for Physical Therapy (PT)?

Our physical therapists will help ensure that you’re in the right physical condition to safely return to your sport/activity. They’ll assess your balance, coordination, strength and endurance while monitoring your heart rate to determine how your body responds to these challenges. How your body responds to progressive exercise will help determine when it’s appropriate for you to return to full-contact activity.

What Can I Expect in Physical Therapy?


Your initial physical therapy (PT) evaluation will take about 60 minutes. You should be prepared to exercise, and bring comfortable workout clothes and tennis shoes. At this first visit, your physical therapist will take your history and discuss the return to activity protocol with you.

Return to Activity Protocol

This protocol, a prescribed plan, consists of four stages of activity. During each stage, your heart rate, symptoms, and response to activities will be monitored to ensure a safe and graduated return to your previous level of activity. Most patients will start at Stage 1 activity level and advance to the next stage every three to five days.

Once you start the plan, it usually takes three to six weeks to complete. The nurse practitioners or physical therapists might recommend moving at a slower or faster pace based on your ImPACT test scores and/or if you have symptoms. We’ll provide you with a written copy of the return to activity plan at the end of your evaluation.

Balance Assessment

You’ll complete a standardized balance assessment at your initial evaluation. Based on your score, we might include more balance activities in your home program or ongoing therapy sessions.

Vestibular/Oculomotor Assessment

Headaches, dizziness and visual problems are common after a brain injury. You’ll do simple tests to ensure that these systems are working properly. Your therapist might use video infrared goggles to help us better view your eye movements and assess for deficits.

After your evaluation, the physical therapist will make recommendations for when you need to return to physical therapy to progress through each stage. You can schedule the ongoing physical therapy visits the same day as your evaluation.

Will I Have Ongoing Physical Therapy Appointments?

We typically see patients for four to eight follow-up visits in physical therapy. Follow-up visits are usually 45 to 60 minutes long. These appointments mostly focus on aerobic exercise, balance, agility drills and strengthening. You can attend any Gillette site (Burnsville, Gillette Lifetime, Maple Grove, Minnetonka or St. Paul) for your ongoing appointments.

When Will I Be Done With Physical Therapy?

We’ll discharge you from physical therapy once you’ve completed Stage 4 activities without the presence of brain injury symptoms. If you’re age 12 or older, you’ll then return to Neurotrauma Clinic to repeat ImPACT testing. There, the nurse practitioners will give the final clearance to return to full-contact activities. After receiving permission to return to full-contact activities, we recommend that you participate in three full practices without restrictions before you play in a game situation.

This information is for educational purposes only. It is not intended to replace the advice of your health care providers. If you have any questions, talk with your doctor or others on your health care team. If you are a Gillette patient with urgent questions or concerns, please contact Telehealth Nursing at 651-229-3890.