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Physical activity and concussion risk in youth ice hockey players: pooled prospective injury surveillance cohorts from Canada.

ABSTRACT: OBJECTIVE:To examine the association between meeting physical activity (PA) volume recommendations and concussion rates in male ice hockey players aged 11-17 years. DESIGN:Pooled prospective injury surveillance cohort data from the 2011-2012, 2013-2014 and 2014-2015 youth ice hockey seasons. PARTICIPANTS:Male Alberta-based Pee Wee (aged 11-12?years), Bantam (aged 13-14?years) and Midget (aged 15-17?years) ice hockey players participating in any of the three cohorts were eligible (n=1726). A total of 1208 players were included after the exclusion criteria were applied (ie, players with new/unhealed injuries within 6?weeks of study entry, missing 6-week PA history questionnaires, missing game and/or practice participation exposure hours, players who sustained concussions when no participation exposure hours were collected). OUTCOME MEASURES:Dependent variable: medically diagnosed concussion. Independent variable: whether or not players' self-reported history of PA (ie, hours of physical education and extracurricular sport participation) met the Canadian Society of Exercise Physiology and Public Health Agency of Canada recommendation of one hour daily during the 6?weeks prior to study entry (ie, 42?hours or more). RESULTS:The PA volume recommendations were met by 65.05% of players who subsequently sustained concussions, and 75.34% of players who did not sustain concussions. The concussion incidence rate ratios (IRR) reflect higher concussion rates in players who did not meet the PA volume recommendations vs. players who met the PA volume recommendations among Pee Wee players (IRR 2.94 95% CI 1.30 to 6.64), Bantam players (IRR 2.18, 95% CI 1.21 to 3.93) and non-elite players aged 11-14 years (IRR 2.45, 95% CI 1.33 to 4.51). CONCLUSION AND RELEVANCE:The concussion rate of players who did not meet the Canadian PA volume recommendations was more than twice the concussion rate of players who met recommendations among male Pee Wee players, Bantam players and non-elite level players. Further exploration of the impact of public health PA recommendations in a sport injury prevention context is warranted.

SUBMITTER: Blake TA

PROVIDER: S-EPMC6129105 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Physical activity and concussion risk in youth ice hockey players: pooled prospective injury surveillance cohorts from Canada.

Blake Tracy A TA Doyle-Baker Patricia K PK Brooks Brian L BL Palacios-Derflingher Luz L Emery Carolyn A CA

BMJ open 20180904 9

<h4>Objective</h4>To examine the association between meeting physical activity (PA) volume recommendations and concussion rates in male ice hockey players aged 11-17 years.<h4>Design</h4>Pooled prospective injury surveillance cohort data from the 2011-2012, 2013-2014 and 2014-2015 youth ice hockey seasons.<h4>Participants</h4>Male Alberta-based Pee Wee (aged 11-12 years), Bantam (aged 13-14 years) and Midget (aged 15-17 years) ice hockey players participating in any of the three cohorts were eli ...[more]

PMID: 30181187

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Project description:IntroductionIce hockey demands a unique blend of physical fitness and skill, necessitating a comprehensive understanding of the factors influencing on-ice performance. The present study was designed to examine the relationship between off-ice and on-ice performance measures in male, youth, ice hockey players.MethodsEleven minor hockey players (Age = 9.8 ± 1.1 years) participated in two testing days: (1) off-ice and (2) on-ice assessments. Off-ice assessments included maximal aerobic power, anaerobic fitness, muscular strength (handgrip and single leg squat), muscular endurance (curl-ups and push-ups), muscular power (standing long jump and vertical jump), and 30 m sprinting speed and acceleration. On-ice testing included a 15.2 m maximum speed test, a 6.1 m acceleration test with a continuation into a 47.9 m top speed test, an agility cornering S turn test, and a shot velocity test.ResultsTwenty-four out of 33 off-ice variables were significantly correlated with at least one of the 11 on-ice performance variables. From those 24, 10 were included as predictors for at least one of the on-ice performance variables. Each model was composed of either one or two predictors, where the most common predictors were 30 m Run - Split (6.1 m) Sprint time and 30 m Run - Total (30 m) Sprint Max speed (included in four out of 11 models each). The prediction formulas R2 and coefficient of variation ranged from 0.63% to 0.96% and 1.2% to 15.3%, respectively.DiscussionDiverse off-ice measures of aerobic fitness, anaerobic power, muscular strength, power, and endurance, and sprinting speed, acceleration, and agility are predictive of on-ice performance. The insights gained from this study contribute to the refinement of assessment protocols, fostering a comprehensive approach to optimizing player performance and potential. Understanding the connection between objective off-ice testing and on-ice performance can support tailored training programs and player development in male youth ice hockey.

Project description:ObjectivesTo examine the association between self-reported exposure to concussion education and knowledge, beliefs and self-reported behaviour among parents and coaches of youth ice hockey players.DesignCross-sectional.SettingCommunity ice hockey teams from Calgary and Edmonton, Alberta, Canada.ParticipantsParents and coaches of ice hockey players (ages 11-17, all divisions of play).Primary and secondary outcome measuresParticipants completed a questionnaire developed and validated to measure concussion knowledge, beliefs and concussion management behaviour (ie, coaches removing athletes from play; parents taking children with suspected concussions to physicians) consistent with the Health Action Process Approach (HAPA). The questionnaire examined specific HAPA constructs (ie, risk perception, outcome expectancies, action self-efficacy, intention, action planning, maintenance self-efficacy, recovery self-efficacy) relevant to concussion management behaviour.ResultsParticipants included 786 parents (31.8% with coaching experience) and 10 non-parent coaches. Of the participants, 649 (82.6%) previously received concussion education. Based on a multivariable regression analysis adjusting for coaching experience, previous history of a child sustaining one or more concussions, first aid experience and cluster by team, exposure to concussion education was associated with a mean score difference of 1.36 (95% CI 0.68 to 2.03), p<0.0001, in the knowledge score. Exposure to concussion education was not significantly associated with any of the HAPA constructs based on Wilcoxon rank-sum tests.ConclusionExposure to concussion education may be associated with small overall differences in concussion knowledge but may not be associated with significant differences in beliefs or intended behaviours related to concussion management among youth hockey parents and coaches.When providing education or recommendations for concussion education sources to coaches and parents, educational strategies grounded in behavioural change theory that specifically target the motivators of behavioural change should be considered.

Project description:Myelin sensitive MRI techniques, such as diffusion tensor imaging and myelin water imaging, have previously been used to reveal changes in myelin after sports-related concussions. What is not clear from these studies, however, is how myelin is affected: whether it becomes degraded and possibly removed, or whether the myelin sheath loosens and becomes "decompacted". Previously, our team revealed myelin specific changes in ice hockey players 2 weeks post-concussion using myelin water imaging. In that study, 45 subjects underwent a pre-season baseline scan, 11 of which sustained a concussion during play and received follow-up scans: eight were scanned within 3 days, 10 were scanned at 14 days, and nine were scanned at 60 days. In the current retrospective analysis, we used quantitative susceptibility mapping, along with the diffusion tensor imaging measures axial diffusivity and radial diffusivity, to investigate this myelin disruption. If sports-related concussive hits lead to myelin fragmentation in regions of lowered MWF, this should result in a measurable increase in magnetic susceptibility, due to the anisotropic myelin fragmenting into isotropic myelin debris, and the diamagnetic myelin tissue being removed, while no such changes should be expected if the myelin sheath simply loosens and becomes decompacted. An increase in radial diffusivity would likewise reveal myelin fragmentation, as myelin sheaths block water diffusion out of the axon, with little to no changes expected for myelin sheath loosening. Statistical analysis of the same voxels-of-interest that were found to have reduced myelin water fraction 2 weeks post-concussion, revealed no statistically significant changes in magnetic susceptibility, axial diffusivity, or radial diffusivity at any time-point post-concussion. This suggests that myelin water fraction changes are likely due to a loosening of the myelin sheath structure, as opposed to fragmentation and removal of myelin debris.

Project description:Background:Pediatric sports specialization, defined as intense year-round training in a single sport as a result of excluding other sports for more than 8 months per year, is common in the United States. There are demonstrated physical and social risks to early pediatric sports specialization (defined as before age 12 years). While thought to be needed to acquire appropriate experience and excel in a given sport, there remains little information on when athletes at the highest levels of their sport specialized. This study aimed to define when professional and collegiate ice hockey players specialized.Hypothesis:Early sports specialization before age 12 years will not be common among elite-level (professional and collegiate) ice hockey players.Study design:Retrospective cross-sectional survey study.Level of evidence:Level 3.Methods:Male professional and collegiate ice hockey players within 1 National Hockey League organization and 2 National Collegiate Athletic Association (NCAA) organizations who were 18 years of age or older completed a survey at training camp detailing their history of sports participation and specialization.Results:A total of 91 athletes participated in the study (mean age, 22.8 years; range, 18-39 years). The mean age at the start of any sports participation was 4.5 years, and the mean age of sports specialization was 14.3 years. The mean age of specialization in the professional group, the NCAA Division I group, and the NCAA Division III group was 14.1, 14.5, and 14.6 years, respectively.Conclusion:Early pediatric sports specialization is not common in elite-level (professional and collegiate) ice hockey players.Clinical relevance:Early pediatric sports specialization before age 12 years is not necessary for athletic success in professional and collegiate ice hockey. This study provides further evidence supporting the recommendations of the American Medical Society for Sports Medicine, American Academy of Pediatrics, and American Orthopaedic Society for Sports Medicine against early sports specialization.

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Physical activity and concussion risk in youth ice hockey players: pooled prospective injury surveillance cohorts from Canada.

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Physical activity and concussion risk in youth ice hockey players: pooled prospective injury surveillance cohorts from Canada.

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