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New Zealand has a high incidence youth concussion (mild traumatic brain injury), which occur as a result of incidents in sport, physical activity or everyday life events. Concussions can lead to headaches, tiredness and difficulty concentrating which can interfere with students' ability to fully participate in learning and sporting related activities at school. The process to recover from a concussion involves mental rest and a gradual return to learning, which can be at odds with continuing academic demands of secondary schooling, potentially influencing student stress and recovery.

Early detection and a managed return to activity is paramount for timely recovery. Yet structured policies and processes are lacking in school-based concussion management of young people, specifically regarding their return to learn. Barriers for managing students with a concussion in a school setting include miscommunication, lack of awareness, indistinct roles and responsibilities, staff education and knowledge of concussions. Students failing to disclose their concussion or symptoms of a suspected concussion to their teachers is also a barrier to enable a full recovery for the student.

This research aims to provide a framework that will outline the 'what', 'where', 'who' and 'how' for managing concussion in secondary schools. Using a collaborative approach, we are developing processes in school-based concussion management, stakeholders' (teachers and coaches) awareness of signs and symptoms and importance of medical care, and students' needs for graduated return to learn.

The research follows a four-stage process

We co-designed FRANCS with stakeholders from six schools in 2021: four schools in Dunedin and two in Auckland (Phase 1a).

In 2022, FRANCS was implemented and evaluated in three schools in Dunedin and two in Hawkes Bay (Phase 1b). The schools adapted the framework based on their local resources and structures.

Students who sustained a concussion and who agreed to be part of the project were tracked by the research team as they progressed though the pathway towards recovery. We also gathered feedback about FRANCS from stakeholders (teachers, parents, students, coaches, manager and healthcare providers; Phase 2a).

We concurrently sought input from sports organisations, healthcare provider organisations, ACC, policy makers and education systems, for advice in preparation for a national roll-out of the framework (Phase 2b).

The outcomes of these evaluations informed Phase 3 in 2023, implementing FRANCS in seven further schools. During Phase 4, we evaluated the process again and refined FRANCS further.

We have gained funding for 2024 to develop more resources for schools and plan to make these available to schools across Aotearoa early in 2025.

Research Funding

Otago Participatory Science Platform (PSP)

Development of a concussion management policy for high schools. Danielle Salmon, Marelise Badenhorst, Gisela Sole, Simon Walters, Chris Whatman, and community and education partners. Amount: $19,680
Collaboration between national governing bodies and regional organisations in Otago to refine a community-designed framework and implement concussion management in Dunedin-based secondary schools.
Danielle Salmon, Gisela Sole, Maria Bentley, Kate Mossmann, Marelise Badenhorst, Patricia Lucas, Simon Walters, and community partners. Amount: $19,680

Lottery Health Grant

Implementation and evaluation of a FRAmework for maNaging Concussions in Secondary schools (FRANCS).
Gisela Sole, Danielle Salmon, Marelise Badenhorst, Kate Mossman, Sierra Keung, Simon Walters. Amount: $120,000

Health Research Council Activation Fund

Connecting rangatahi with concussion management
Simon Walters, Anja Zoellner, Chris Whatman, Kylie Thomson, Gisela Sole. Amount: $30,000

Auckland University of Technology, Faculty of Health and Environmental Sciences, Research Development Fund

Evaluation of the implementation of a FRAmework for managing Concussions in secondary Schools (FRANCS).
Anja Zoellner, Simon Walters, Sierra Keung, Patricia Lucas, Kylie Thompson, Marelise Badenhorst, Gisela Sole. Amount: $8,230.26


Peer-reviewed Journal Articles

Salmon DM, Badenhorst M, Keung S, Lucas P, Mossman K, Thompson K, Walters S, Sole G (2023). Designing, implementing and evaluating a framework for managing concussions in New Zealand secondary schools: a study protocol. NZ Journal of Physiotherapy, 51(3), S1-S9


Study to look at youth concussions, The Star, 18th November 2021.

NZ Rugby piloting return to learning concussion program, 1news, 22nd June 2022.

New Zealand's teenage concussion issue: Rugby pushes for national guidelines to erase blurred lines, Stuff, 26th June 2022


Mossman K, Sole G, Badenhorst M, Salmon D, Sutherland C, Lucas P. Concussion management in secondary schools. New Zealand Secondary Schools Sports Conference, Wellington NZ, 23 September 2022

Research Team

Project leads:
Professor Gisela Sole (Centre for Health, Activity and Rehabilitation Research, CHARR, School of Physiotherapy, University of Otago)
Dr Danielle Salmon (World Rugby)
Associate Professor Simon Walters (School of Sport and Recreation, - Auckland University of Technology)

Dr Marelise Badenhorst (Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology)
Richelle Caya (CHARR, School of Physiotherapy, University of Otago)
Mark Hurdley (CHARR, School of Physiotherapy, University of Otago)
Dr Sierra Keung (SPRINZ, Auckland University of Technology)
Dr Patricia Lucas (School of Sport and Recreation, Auckland University of Technology)
Dr Kate Mossman (CHARR, School of Physiotherapy, University of Otago)
Debbie Skilton (SPRINZ, Auckland University of Technology)
Kylie Thompson (SPRINZ, Auckland University of Technology)
Christina Sutherland (CHARR, School of Physiotherapy, University of Otago)
Dr Anja Zoellner (SPRINZ, Auckland University of Technology)

Contact Us

For more details about this study please email Professor Gisela Sole at

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