Expert Voices: Alyssa Memmini, Ph.D., LAT, ATC on performing artists' Return-to-Stage after concussion

This article was initially published in the 6/25/26 edition of our Concussion Update newsletter; please consider subscribing.

Alyssa Memmini, a member of Concussion Alliance’s Expert Advisory Board, recently led a team that developed a return-to-the-stage protocol for collegiate performing artists after a concussion.

Performing artists are a critically underserved population of athletes who lack clear guidance on post-concussion management strategies despite similar physical demands as sport athletes. Common mechanisms of concussion include falling from elevated surfaces, poor technique during partnering, as well as collisions with other performers, props, or apparatuses. Thus, our team first conducted a systematic review to identify current clinical management strategies to support university performing artists after concussion, which resulted in a nearly empty review. Therefore, we conducted a Delphi study (a structured way of reaching consensus among different stakeholders) to develop the first post-concussion recommendations to be implemented across a variety of performing arts disciplines. The Delphi panel consisted of university-affiliated clinicians (e.g., physicians, physical therapists, etc.), concussion researchers ranging from post-doctoral fellows to tenured faculty, academic advisors in performing arts programs, and, most importantly, performing arts alumni with history of concussion during their university training. The resultant product of the Delphi process (Progressive Return-to-Performance Protocol) follows the six-step strategy proposed by the International Concussion in Sport Group, except with specific strategies for dancers, instrumentalists, and actors to safely progress back to their performance environment after concussion. Importantly, this protocol may be used as a framework for performing arts students to collaborate with their instructors and may be modified to meet individualized needs of performers.