R2P PATHTM: A Comprehensive Approach

It is generally recognized that neuro-pathological and psychological factors underlie persistent post-concussion symptoms. Clinicians are often poorly equipped to manage patients that present with them.

This advanced level course offers a comprehensive approach to the management of complex concussion symptoms using evidence-based algorithms to guide a differential diagnosis. This course builds on R2P SCORETM and introduces R2P PATHTM, which is a criteria-based exercise progression model integrating graduated physical activity and vestibular, visual, and cognitive challenges, to create individualized treatment plans.

Through lectures, practical sessions, and case studies, participants will gain valuable insight into management of complex post-concussion symptoms and current best practices.

This is the third in a series of three courses on managing acute through persistent post- concussion symptoms.


This full day course builds upon R2P SCORETM. Key principles of progressive overload within sub- threshold activity levels will guide the selection of criteria-based treatment progressions using R2P PATHTM. Participants will learn innovative rehabilitative techniques such as advanced vestibular, and ocular motor exercises, and how to apply them within the framework of international guidelines. Common co-pathologies will be discussed in the context of post-concussion, with a focus on post-traumatic headache, depression, and anxiety. Strategies for differential diagnosis will be explored using a series of unique algorithms.

Prerequisite: R2PTM Management of Post- Concussion Syndrome

Toronto, ON

May 7, 2017
$295.00 +HST
Payment by VISA or MasterCard must accompany the completed online registration form. Registration includes light refreshments, course manual, and a certificate of attendance.
Register online at:

Clinical Instructor
Jacquie van Ierssel
Jacquie has treated athletes at a recreational through to Olympic level as a physiotherapist for over 14 years. During over a decade of clinical and on-field experience at the University of Toronto with the concussion clinic and research staff, Jacquie has treated a high volume of complex concussion patients, with a focus on return to play. Her continuum of care included facilitating neuro-psychological baseline testing, acute on-field assessment of injured athletes, management of acute and chronic symptoms, and return to play exercise progressions. Additionally, she completed her vestibular competency training at Emory University. She has been a clinical instructor at the University of Toronto, Department of Physical Therapy, and past chair of the Sport Physiotherapy Canada (SPC), Ontario committee which she sat on for over 12years. Jacquie is currently a PhD candidate at the University of Ottawa, developing a Quality of Life outcome measure to direct treatment for patients with post-concussion syndrome.
For further information contact: R2Pconcussion@gmail.com



8:30 Review R2P SCORETM as a determinant of treatment priorities and clinical care pathways using case studies.
9:00 Common co-pathologies seen in complex concussion patients, including post-traumatic headache, depression and anxiety; shared pathophysiology with post- concussion symptoms; current treatment options, including commonly prescribed medications.
10:30 Comprehensive history taking; evidence-based algorithm to differentially diagnose post-traumatic headache and apply best practice treatment.
11:00 Introduction to R2P PATHTM; understand how to prescribe criteria-based step-wise treatment progressions based on individual functional limitations.
11:30 Lunch
12:30 Advanced therapeutic exercise for vestibular and balance dysfunction; stepwise treatment progressions; practical session
1:30 Advanced therapeutic exercises for ocular motor dysfunction; stepwise treatment progressions; practical session
2:30 Practical application of R2P PATHTM using principles of symptom-based limitations to prescribe individual treatment plans integrating graduated physical activity with vestibular, visual and cognitive challenges using sub-threshold exercises.
3:30 Case studies with individualized treatment prescriptions.
4:00 Questions and Answers