MACE Return-to-Duty & Recovery Protocols — Questions and Answers
Question 1: What is the military progressive return-to-activity protocol after concussion?
- A stepwise program progressing from rest through light activity, moderate exercise, full exertion, and return to duty, with minimum 24 hours at each stage (Correct answer)
- Immediate return to full duty
- A single fitness test before returning to duty
- Rest for 30 days with no evaluation
Correct answer: A stepwise program progressing from rest through light activity, moderate exercise, full exertion, and return to duty, with minimum 24 hours at each stage
The military uses a graduated return-to-activity protocol similar to civilian sport concussion guidelines: symptom-limited rest, light aerobic exercise, sport-specific exercise, full-contact practice equivalent, and return to duty.
Question 2: What is the mandatory rest period after a diagnosed concussion in the US military?
- A minimum 24-hour rest period with medical evaluation before beginning the return-to-duty progression (Correct answer)
- No rest period is required
- 48 hours of complete bed rest
- Return to duty immediately after the MACE
Correct answer: A minimum 24-hour rest period with medical evaluation before beginning the return-to-duty progression
Department of Defense policy mandates a minimum 24-hour rest period after concussion diagnosis, during which the service member is restricted from duty, driving, and operating equipment, with medical monitoring.
Question 3: What criteria must be met before a concussed service member can return to full duty?
- Symptom-free at rest and during exertion, normal MACE scores, normal neurological examination, and completion of the progressive return-to-activity protocol (Correct answer)
- Only the service member's desire to return
- Passing a physical fitness test
- One week of rest regardless of symptoms
Correct answer: Symptom-free at rest and during exertion, normal MACE scores, normal neurological examination, and completion of the progressive return-to-activity protocol
Return to full duty requires: complete symptom resolution at rest and during progressive exertion, normalized cognitive testing, normal neurological exam, and successful completion of all stages of the graded activity protocol.
Question 4: How does exertional testing factor into return-to-duty decisions?
- Service members must demonstrate they can perform physical exertion without symptom recurrence before returning to full duty (Correct answer)
- Physical exertion is never tested
- Only desk-duty positions require exertion testing
- Exertional testing is optional
Correct answer: Service members must demonstrate they can perform physical exertion without symptom recurrence before returning to full duty
Exertional testing is critical because concussion symptoms often recur with physical and cognitive stress. Service members must tolerate progressively increasing activity levels without symptom exacerbation before returning to duty.
Question 5: What is the role of the unit leadership in concussion management?
- Identifying potentially concussed service members, ensuring they receive medical evaluation, enforcing activity restrictions, and monitoring compliance with recovery protocols (Correct answer)
- Unit leaders have no role in medical decisions
- Only medics handle concussions
- Leaders should encourage rapid return to duty
Correct answer: Identifying potentially concussed service members, ensuring they receive medical evaluation, enforcing activity restrictions, and monitoring compliance with recovery protocols
Commanders and NCOs play a critical role by recognizing concussive events, ensuring prompt medical evaluation, enforcing duty restrictions, providing modified duty assignments, and supporting the recovery process.
Question 6: What activity restrictions apply to service members with diagnosed concussion?
- No driving, no operating heavy equipment/weapons, no flying, limited screen time, adequate sleep, and reduced cognitive demands (Correct answer)
- No restrictions are necessary
- Only combat is restricted
- Only flying is restricted
Correct answer: No driving, no operating heavy equipment/weapons, no flying, limited screen time, adequate sleep, and reduced cognitive demands
Activity restrictions protect the recovering brain: no driving or operating machinery, restricted screen time, adequate sleep, limited cognitive workload, no contact sports, and no alcohol, with gradual lifting as symptoms resolve.
MACE Return-to-Duty & Recovery Protocols
What is the military progressive return-to-activity protocol after concussion?