DOI: 10.1227/neuprac.0000000000000274 ISSN: 2834-4383

Protocol for Development of Guidelines for Rapid Restoration of Readiness

Simon Oczkowski, Thomas Bayuk, Bradley A. Dengler, Michael McCrea, Sameer Sharif, Katie Stout, Gregory W. J. Hawryluk, Halinder S. Mangat, Jamshid Ghajar

Combat and sport require individuals to be ready for successful completion of the task at hand. Cognitive readiness and attention may be impaired for many reasons, including concussion or subconcussive injury, insufficient sleep, fatigue, or any other disruption or deviation of baseline physiology. While rapid readiness screening may identify individuals who are not “ready” for a given task, it is also important to find interventions which can rapidly return an individual to a state of readiness. Although general health practices such as nutrition, physical conditioning, and adequate rest support overall performance, targeted interventions—focused on oculo-vestibular, verbal-cognitive function, and motor control—may accelerate return to readiness. Additional modalities such as structured sleep optimization protocols, controlled stimulant use, and specific supplements may also contribute to rapid restoration. This paper describes an evidence-based framework for developing guidelines that identify, evaluate, and implement rapid readiness restoration strategies across diverse preclinical settings, including military far-forward environments, sports sidelines, and garrison or training contexts.

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