1
|
Critelli K, Demiris V, Klatt BN, Crane B, Anson ER. Facemasks Block Lower Visual Field in Youth Ice Hockey. Front Sports Act Living 2021; 3:787182. [PMID: 34939030 PMCID: PMC8685261 DOI: 10.3389/fspor.2021.787182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/11/2021] [Indexed: 11/13/2022] Open
Abstract
Wearing a facemask (FM) reduces the spread of COVID-19, but it also blocks a person's lower visual field. Many new public safety rules were created in response to COVID-19, including mandated FM wearing in some youth sports like youth ice hockey. We hypothesized that FM wearing in youth hockey players obstructs the lower field of view and may impact safety. Youth hockey players (n = 33) aged 12.03 (1.6) years button press when they saw an LED on the floor turn on in two conditions (wearing FM or no FM) in random order. An interleaved one-up/one-down two-alternative-forced-choice adaptive staircase design was used. Visual thresholds were calculated for each condition and participant. The visual angle threshold (VAT) was determined using standing eye height and the linear distance from the tip of the skates to the visual threshold. Paired t-tests determined whether mask wearing changed the VAT. We modeled the probability a player could see the puck on their stick in four distinct scenarios to estimate the potential impact of FM wearing during hockey play. The average unmasked VAT (11.4 degrees) was significantly closer to the skates than the masked VAT (20.3 degrees) (p < 0.001). Our model indicated a significant reduction in ability to visualize the puck using peripheral vision when more upright while wearing a FM. FM wearing compromised their lower visual field, suggesting a downward head tilt may be necessary to see the puck. Playing ice hockey while wearing a FM may lead to unsafe on-ice playing conditions due to downward head tilt to see the puck.
Collapse
Affiliation(s)
- Kyle Critelli
- Department of Otolaryngology, University of Rochester, Rochester, NY, United States
| | - Victoria Demiris
- Physical Therapy Department, University of Rochester, Rochester, NY, United States
| | - Brooke N Klatt
- Physical Therapy Department, University of Pittsburgh, Pittsburgh, PA, United States
| | - Benjamin Crane
- Department of Otolaryngology, University of Rochester, Rochester, NY, United States.,Department of Neuroscience, University of Rochester, Rochester, NY, United States.,Department of Biomedical Engineering, University of Rochester, Rochester, NY, United States
| | - Eric R Anson
- Department of Otolaryngology, University of Rochester, Rochester, NY, United States.,Physical Therapy Department, University of Rochester, Rochester, NY, United States.,Department of Neuroscience, University of Rochester, Rochester, NY, United States
| |
Collapse
|
2
|
Reed N, Taha T, Greenwald R, Keightley M. Player and Game Characteristics and Head Impacts in Female Youth Ice Hockey Players. J Athl Train 2017; 52:771-775. [PMID: 28715282 DOI: 10.4085/1062-6050-52.5.04] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Despite the growing popularity of ice hockey among female youth and interest in the biomechanics of head impacts in sport, the head impacts sustained by this population have yet to be characterized. OBJECTIVES To describe the number of, biomechanical characteristics of, and exposure to head impacts of female youth ice hockey players during competition and to investigate the influences of player and game characteristics on head impacts. DESIGN Cohort study. METHODS Twenty-seven female youth ice hockey players (mean age = 12.5 ± 0.52 years) wore instrumented ice hockey helmets during 66 ice hockey games over a 3-year period. Data specific to player, game, and biomechanical head impact characteristics were recorded. A multiple regression analysis identified factors most associated with head impacts of greater frequency and severity. RESULTS A total of 436 total head impacts were sustained during 6924 minutes of active ice hockey participation (0.9 ± 0.6 impacts per player per game; range, 0-2.1). A higher body mass index (BMI) significantly predicted a higher number of head impacts sustained per game (P = .008). Linear acceleration of head impacts was greater in older players and those who played the forward position, had a greater BMI, and spent more time on the ice (P = .008), whereas greater rotational acceleration was present in older players who had a greater BMI and played the forward position (P = .008). During tournament games, increased ice time predicted increased severity of head impacts (P = .03). CONCLUSIONS This study reveals for the first time that head impacts are occurring in female youth ice hockey players, albeit at a lower rate and severity than in male youth ice hockey players, despite the lack of intentional body checking.
Collapse
Affiliation(s)
- Nick Reed
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Canada.,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Canada
| | - Tim Taha
- Faculty of Kinesiology and Physical Education, University of Toronto, Canada
| | - Richard Greenwald
- Simbex, Lebanon, NH.,Thayer School of Engineering, Dartmouth College, Hanover, NH
| | - Michelle Keightley
- Department of Occupational Science and Occupational Therapy, University of Toronto, Canada
| |
Collapse
|
3
|
Popkin CA, Schulz BM, Park CN, Bottiglieri TS, Lynch TS. Evaluation, management and prevention of lower extremity youth ice hockey injuries. Open Access J Sports Med 2016; 7:167-176. [PMID: 27920584 PMCID: PMC5123732 DOI: 10.2147/oajsm.s118595] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Ice hockey is a fast-paced sport played by increasing numbers of children and adolescents in North America and around the world. Requiring a unique blend of skill, finesse, power and teamwork, ice hockey can become a lifelong recreational activity. Despite the rising popularity of the sport, there is ongoing concern about the high frequency of musculoskeletal injury associated with participation in ice hockey. Injury rates in ice hockey are among the highest in all competitive sports. Numerous research studies have been implemented to better understand the risks of injury. As a result, rule changes were adopted by the USA Hockey and Hockey Canada to raise the minimum age at which body checking is permitted to 13–14 years (Bantam level) from 11–12 years (Pee Wee). Continuing the education of coaches, parents and players on rules of safe play, and emphasizing the standards for proper equipment use are other strategies being implemented to make the game safer to play. The objective of this article was to review the evaluation, management and prevention of common lower extremity youth hockey injuries.
Collapse
Affiliation(s)
- Charles A Popkin
- Department of Orthopedic Surgery, Center for Shoulder, Elbow and Sports Medicine at Columbia University, New York, NY
| | | | - Caroline N Park
- Department of Orthopedic Surgery, Center for Shoulder, Elbow and Sports Medicine at Columbia University, New York, NY
| | - Thomas S Bottiglieri
- Department of Orthopedic Surgery, Center for Shoulder, Elbow and Sports Medicine at Columbia University, New York, NY
| | - T Sean Lynch
- Department of Orthopedic Surgery, Center for Shoulder, Elbow and Sports Medicine at Columbia University, New York, NY
| |
Collapse
|
4
|
Goulet C, Roy TO, Nadeau L, Hamel D, Fortier K, Emery CA. The Incidence and Types of Physical Contact Associated with Body Checking Regulation Experience in 13-14 Year Old Ice Hockey Players. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13070668. [PMID: 27399750 PMCID: PMC4962209 DOI: 10.3390/ijerph13070668] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 06/24/2016] [Accepted: 06/29/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Ice hockey has one of the highest sport participation and injury rates in youth in Canada. Body checking (BC) is the predominant mechanism of injury in leagues in which it is permitted. The objectives of this study were to determine whether the incidence and types of physical contact differ for Bantam players (aged 13-14 years) who were exposed to BC at Pee Wee level (aged 11-12 years) in Calgary, Alberta versus Bantam players who were not exposed to BC at Pee Wee level in Québec City, Québec. All teams were exposed to BC at bantam level; METHODS A cohort study was conducted in Québec City and Calgary. Sixteen games for Calgary and 15 for Québec City were randomly selected and analysed with a validated observation system to quantify five intensities of physical contact and to observe different types of physical contact such as slashing and holding; RESULTS A total of 5610 incidences of physical contact with the trunk and 3429 other types of physical contact were observed. Very light intensity trunk contact was more frequent in Calgary (adjusted incidence RR (ARR): 1.71; 95% CI: 1.28-2.29). Holding (ARR: 1.04; 95% CI: 1.02-1.07) and slashing (ARR: 1.38; 95% CI: 1.07-1.77) were more frequent in Calgary; CONCLUSION RESULTS suggest that players' physical contacts differ between Bantam leagues in which BC was permitted at Pee Wee level and leagues in which it was not permitted until Bantam level.
Collapse
Affiliation(s)
- Claude Goulet
- Department of Physical Education, Faculty of Education, Laval University, Québec, QC G1V 0A6, Canada.
| | - Thierry-Olivier Roy
- Department of Kinesiology, Faculty of Medicine, Laval University, Québec, QC G1V 0A6, Canada.
| | - Luc Nadeau
- Department of Physical Education, Faculty of Education, Laval University, Québec, QC G1V 0A6, Canada.
| | - Denis Hamel
- Québec Public Health Institute, Québec, QC G1V 5B3, Canada.
| | - Kristine Fortier
- Department of Physical Education, Faculty of Education, Laval University, Québec, QC G1V 0A6, Canada.
| | - Carolyn A Emery
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada.
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB T2N 4N1, Canada.
- Department of Pediatrics and Community Health Sciences, Cumming School of Medicine, Faculty of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.
| |
Collapse
|
5
|
Cusimano MD, Ilie G, Mullen SJ, Pauley CR, Stulberg JR, Topolovec-Vranic J, Zhang S. Aggression, Violence and Injury in Minor League Ice Hockey: Avenues for Prevention of Injury. PLoS One 2016; 11:e0156683. [PMID: 27258426 PMCID: PMC4892613 DOI: 10.1371/journal.pone.0156683] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 05/18/2016] [Indexed: 11/18/2022] Open
Abstract
Background In North America, more than 800,000 youth are registered in organized ice hockey leagues. Despite the many benefits of involvement, young players are at significant risk for injury. Body-checking and aggressive play are associated with high frequency of game-related injury including concussion. We conducted a qualitative study to understand why youth ice hockey players engage in aggressive, injury-prone behaviours on the ice. Methods Semi-structured interviews were conducted with 61 minor ice hockey participants, including male and female players, parents, coaches, trainers, managers and a game official. Players were aged 13–15 playing on competitive body checking teams or on non-body checking teams. Interviews were manually transcribed, coded and analyzed for themes relating to aggressive play in minor ice hockey. Results Parents, coaches, teammates and the media exert a large influence on player behavior. Aggressive behavior is often reinforced by the player’s social environment and justified by players to demonstrate loyalty to teammates and especially injured teammates by seeking revenge particularly in competitive, body-checking leagues. Among female and male players in non-body checking organizations, aggressive play is not reinforced by the social environment. These findings are discussed within the framework of social identity theory and social learning theory, in order to understand players’ need to seek revenge and how the social environment reinforces aggressive behaviors. Conclusion This study provides a better understanding of the players’ motivations and environmental influences around aggressive and violent play which may be conducive to injury. The findings can be used to help design interventions aimed at reducing aggression and related injuries sustained during ice hockey and sports with similar cultures and rules.
Collapse
Affiliation(s)
- Michael D. Cusimano
- Division of Neurosurgery, Department of Surgery, Injury Prevention Research Office, Saint Michael’s Hospital, Toronto, Ontario, Canada
- * E-mail:
| | - Gabriela Ilie
- Dalhousie University Faculty of Medicine, Department of Community Health and Epidemiology, Halifax, Nova Scotia, Canada
| | - Sarah J. Mullen
- Division of Neurosurgery, Department of Surgery, Injury Prevention Research Office, Saint Michael’s Hospital, Toronto, Ontario, Canada
| | - Christopher R. Pauley
- Division of Neurosurgery, Department of Surgery, Injury Prevention Research Office, Saint Michael’s Hospital, Toronto, Ontario, Canada
| | | | - Jane Topolovec-Vranic
- Faculty of Medicine (Occupational Science and Occupational Therapy), University of Toronto, Toronto, Canada
| | - Stanley Zhang
- Division of Neurosurgery, Department of Surgery, Injury Prevention Research Office, Saint Michael’s Hospital, Toronto, Ontario, Canada
| |
Collapse
|
6
|
MacCormick L, Best TM, Flanigan DC. Are There Differences in Ice Hockey Injuries Between Sexes?: A Systematic Review. Orthop J Sports Med 2014; 2:2325967113518181. [PMID: 26535265 PMCID: PMC4555524 DOI: 10.1177/2325967113518181] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Men’s ice hockey allows for body checking, and women’s ice hockey prohibits it. Studies have reported injury data on both sexes, but no systematic reviews have compared the injury patterns between male and female ice hockey players. Hypothesis: Men’s and women’s ice hockey would have different types of injuries, and this difference would extend across the different age groups and levels of play. Study Design: Systematic review; Level of evidence, 4. Methods: Three databases, 3 scientific journals, and selected bibliographies were searched to identify articles relevant to this study. Articles were further screened by the use of predetermined inclusion and exclusion criteria. Twenty-two studies met these criteria and were subsequently reviewed. Results: Men sustained higher rates of injuries than women at all age levels, and both sexes sustained at least twice as many injuries in games than practices. Both sexes sustained most of their injuries from player contact. Men and women in college sustained most injuries to the head and face, and women suffered from higher percentages of concussion. At all ages and levels of play, men had higher rates of upper extremity injuries (shoulder), while women were found to sustain more injuries to the lower extremity (thigh, knee). Conclusion: Although findings showed men sustaining higher rates of injuries than women, the predominant mechanism of player contact was the same. The most common locations and types of injuries in female ice hockey players are comparable to other sports played by women, and similar interventions could offer protection against injury. Clinical Relevance: Further studies that report injury data for women playing ice hockey at all levels will assist in understanding what prevention strategies should be implemented.
Collapse
Affiliation(s)
| | - Thomas M Best
- OSU Sports Medicine, The Ohio State University, Columbus, Ohio, USA. ; Sports Health & Performance Institute, The Ohio State University, Columbus, Ohio, USA. ; Department of Family Medicine, The Ohio State University, Columbus, Ohio, USA
| | - David C Flanigan
- OSU Sports Medicine, The Ohio State University, Columbus, Ohio, USA. ; Sports Health & Performance Institute, The Ohio State University, Columbus, Ohio, USA. ; Department of Orthopaedics, The Ohio State University, Columbus, Ohio, USA. ; Investigation performed at The Ohio State University, Columbus, Ohio, USA
| |
Collapse
|
7
|
Bachynski KE, Goldberg DS. Youth sports & public health: framing risks of mild traumatic brain injury in american football and ice hockey. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2014; 42:323-333. [PMID: 25264090 DOI: 10.1111/jlme.12149] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The framing of the risks of experiencing mild traumatic brain injury in American football and ice hockey has an enormous impact in defining the scope of the problem and the remedies that are prioritized. According to the prevailing risk frame, an acceptable level of safety can be maintained in these contact sports through the application of technology, rule changes, and laws. An alternative frame acknowledging that these sports carry significant risks would produce very different ethical, political, and social debates.
Collapse
Affiliation(s)
- Kathleen E Bachynski
- A Ph.D. candidate in the Department of Sociomedical Sciences at Columbia University Mailman School of Public Health in New York, NY
| | | |
Collapse
|
8
|
Cusimano MD, Nastis S, Zuccaro L. Effectiveness of interventions to reduce aggression and injuries among ice hockey players: a systematic review. CMAJ 2012; 185:E57-69. [PMID: 23209118 DOI: 10.1503/cmaj.112017] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND The increasing incidence of injuries related to playing ice hockey is an important public health issue. We conducted a systematic review to evaluate the effectiveness of interventions designed to reduce injuries related to aggressive acts in ice hockey. METHODS We identified relevant articles by searching electronic databases from their inception through July 2012, by using Internet search engines, and by manually searching sports medicine journals, the book series Safety in Ice Hockey and reference lists of included articles. We included studies that evaluated interventions to reduce aggression-related injuries and reported ratings of aggressive behaviour or rates of penalties or injuries. RESULTS We identified 18 eligible studies. Most involved players in minor hockey leagues. Of 13 studies that evaluated changes in mandatory rules intended to lessen aggression (most commonly the restriction of body-checking), 11 observed a reduction in penalty or injury rates associated with rule changes, and 9 of these showed a statistically significant decrease. The mean number of penalties decreased by 1.2-5.9 per game, and injury rates decreased 3- to 12-fold. All 3 studies of educational interventions showed a reduction in penalty rates, but they were not powered or designed to show a change in injury rates. In 2 studies of cognitive behavioural interventions, reductions in aggressive behaviours were observed. INTERPRETATION Changes to mandatory rules were associated with reductions in penalties for aggressive acts and in injuries related to aggression among ice hockey players. Effects of educational and cognitive behavioural interventions on injury rates are less clear. Well-designed studies of multifaceted strategies that combine such approaches are required.
Collapse
Affiliation(s)
- Michael D Cusimano
- Division of Neurosurgery, and the Injury Prevention Research Office, Keenan Research Centre, St. Michael’s Hospital, University of Toronto, Toronto, Ont., Canada.
| | | | | |
Collapse
|
9
|
Emery C, Kang J, Shrier I, Goulet C, Hagel B, Benson B, Nettel-Aguirre A, McAllister J, Meeuwisse W. Risk of injury associated with bodychecking experience among youth hockey players. CMAJ 2011; 183:1249-56. [PMID: 21690221 DOI: 10.1503/cmaj.101540] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND In a previous prospective study, the risk of concussion and all injury was more than threefold higher among Pee Wee ice hockey players (ages 11-12 years) in a league that allows bodychecking than among those in a league that does not. We examined whether two years of bodychecking experience in Pee Wee influenced the risk of concussion and other injury among players in a Bantam league (ages 13-14) compared with Bantam players introduced to bodychecking for the first time at age 13. METHODS We conducted a prospective cohort study involving hockey players aged 13-14 years in the top 30% of divisions of play in their leagues. Sixty-eight teams from the province of Alberta (n = 995), whose players had two years of bodychecking experience in Pee Wee, and 62 teams from the province of Quebec (n = 976), whose players had no bodychecking experience in Pee Wee, participated. We estimated incidence rate ratios (IRRs) for injury and for concussion. RESULTS There were 272 injuries (51 concussions) among the Bantam hockey players who had bodychecking experience in Pee Wee and 244 injuries (49 concussions) among those without such experience. The adjusted IRRs for game-related injuries and concussion overall between players with bodychecking experience in Pee Wee and those without it were as follows: injury overall 0.85 (95% confidence interval [CI] 0.63 to 1.16); concussion overall 0.84 (95% CI 0.48 to 1.48); and injury resulting in more than seven days of time loss (i.e., time between injury and return to play) 0.67 (95% CI 0.46 to 0.99). The unadjusted IRR for concussion resulting in more than 10 days of time loss was 0.60 (95% CI 0.26 to 1.41). INTERPRETATION The risk of injury resulting in more than seven days of time loss from play was reduced by 33% among Bantam hockey players in a league where bodychecking was allowed two years earlier in Pee Wee compared with Bantam players introduced to bodychecking for the first time at age 13. In light of the increased risk of concussion and other injury among Pee Wee players in a league where bodychecking is permitted, policy regarding the age at which hockey players are introduced to bodychecking requires further consideration.
Collapse
Affiliation(s)
- Carolyn Emery
- Sport Injury Prevention Research Centre, Roger Jackson Centre for Health and Wellness Research, Faculty of Kinesiology, University of Calgary, Calgary, Canada.
| | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Spinks AB, McClure RJ. Quantifying the risk of sports injury: a systematic review of activity-specific rates for children under 16 years of age. Br J Sports Med 2007; 41:548-57; discussion 557. [PMID: 17473004 PMCID: PMC2465389 DOI: 10.1136/bjsm.2006.033605] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2007] [Indexed: 11/03/2022]
Abstract
Injuries caused by sports and other forms of physical activity in young children constitute a significant public health burden. It is important to quantify this risk to ensure that the benefits of sport participation are not outweighed by the potential harms. This review summarises the literature reporting exposure-based injury rates for various forms of physical activity in children aged 15 years and younger. Forty eight studies were found, of which 27 reported injury rates per hourly based exposure measured and 21 reported injury rates according to some other measure. Fourteen different sports and activities were covered, mostly team ball sports, with soccer being the most widely studied. Injury definition and the method of ascertaining and measuring injuries differed between studies, which created a large variation in reported injury rates that did not necessarily represent actual differences in injury risk between activities. The highest hourly based injury rates were reported for ice hockey, and the lowest were for soccer, although the range of injury rates for both of these activities was wide. Very few studies have investigated sports-related injuries in children younger than 8 years or in unorganised sports situations.
Collapse
Affiliation(s)
- Anneliese B Spinks
- School of Medicine, Griffith University, Meadowbrook, Queensland, Australia.
| | | |
Collapse
|
11
|
Affiliation(s)
- W James King
- Division of Pediatric Medicine, Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ont.
| | | |
Collapse
|
12
|
Williamson IJS, Goodman D. Converging evidence for the under-reporting of concussions in youth ice hockey. Br J Sports Med 2006; 40:128-32; discussion 128-32. [PMID: 16431999 PMCID: PMC2492052 DOI: 10.1136/bjsm.2005.021832] [Citation(s) in RCA: 190] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Concussions are potentially serious injuries. The few investigations of prevalence or incidence in youth ice hockey have typically relied on prospective reports from physicians or trainers and did not survey players, despite the knowledge that many athletes do not report probable concussions. OBJECTIVE This study sought to compare concussion rates in youth ice hockey that were estimated from a variety of reporting strategies. METHODS Rates were calculated from British Columbia Amateur Hockey Association (BCAHA) official injury reports, from direct game observation by minor hockey volunteers (such as coaches and managers), as well as from retrospective surveys of both elite and non-elite youth players. All research was conducted within the BCAHA. RESULTS Estimates from official injury reports for male players were between 0.25 and 0.61 concussions per 1000 player game hours (PGH). Concussion estimates from volunteer reports were between 4.44 and 7.94 per 1000 PGH. Player survey estimates were between 6.65 and 8.32 per 1000 PGH, and 9.72 and 24.30 per 1000 PGH for elite and non-elite male youth hockey, respectively. CONCLUSION It was found that concussions are considerably under-reported to the BCAHA by youth hockey players and team personnel.
Collapse
|
13
|
Abstract
BACKGROUND Body checking is the predominant mechanism of youth ice hockey injuries. The Canadian Hockey Association has allowed body checking from ages 12 to 13 (peewee level) and up. One Canadian province (Ontario) introduced body checking at ages 10 to 11 (atom level) in the competitive leagues, whereas in Quebec body checking has only been allowed at ages 14 to 15 (bantam Level). The purpose of this study was to compare body-checking injuries, fractures, and concussions in boys' minor hockey between jurisdictions in which checking is allowed and jurisdictions in which body checking is not allowed. METHODS Data from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) were used to characterize children's ice hockey injuries from September 1995 to the end of August 2002. Children treated at CHIRPP hospitals in areas in which checking was allowed were compared with children in areas in which checking was not allowed. RESULTS Of the 4736 hockey injuries, 3006 (63%) were in Ontario and 1730 (37%) were in Quebec. Most of the injuries occurred in areas in which checking was allowed (3618 [76.4%]) [corrected] At ages 10 to 13, players had significantly greater odds of suffering a checking injury where checking was allowed (odds ratio [OR]: 2.65 [corrected]; 95% confidence interval [CI]: 2.21[corrected]-3.18 [corrected]). Players in this age group were also more likely to suffer a concussion (OR: 1.53 [corrected]; 95% CI: 0.93 [corrected]-2.52 [corrected]) or fracture (OR: 1.20 [corrected]; 95% CI: 1.00 [corrected]-1.47) where checking was allowed. Among older players, when checking was allowed in both provinces, there were higher odds (OR: 1.1 [corrected]; 95% CI: 0.94 [corrected]-1.33 [corrected]) of receiving a checking injury in the province that had introduced checking at a younger age, suggesting that there is no protective effect from learning to check earlier. CONCLUSIONS Increased injuries attributable to checking were observed where checking was allowed. This study supports policies that disallow body checking to reduce ice hockey injuries in children.
Collapse
Affiliation(s)
- Alison Macpherson
- School of Kinesiology and Health Sciences, York University, Toronto, Ontario, Canada.
| | | | | |
Collapse
|
14
|
Hostetler SG, Xiang H, Smith GA. Characteristics of ice hockey-related injuries treated in US emergency departments, 2001-2002. Pediatrics 2004; 114:e661-6. [PMID: 15574599 DOI: 10.1542/peds.2004-1565] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Ice hockey, a popular sport in some regions, has potential for injury due to the velocities of players, pucks, and sticks. Previous studies conducted worldwide have shown that the rate of injury increases as the size and the speed of players increase, as well as when checking is allowed. However, national data about the annual number and types of injuries among ice hockey players are lacking. Data from previous studies were collected from regional tournaments, collegiate teams, local emergency departments (EDs), and different countries. The purpose of this article is to examine ice hockey injuries using a national US database to determine the age distribution of total injuries, injury types, and body regions injured, with a particular focus on ice hockey players <18 years old. METHODS Data regarding ice hockey-related injuries treated in US EDs between January 1, 2001, and December 31, 2002, were extracted from the National Electronic Injury Surveillance System (NEISS). Data considered included age, gender, race, injury diagnosis, and body region injured. Ice hockey-related injury cases were identified using the consumer product code for ice hockey and the narrative description of the incident in NEISS. RESULTS An estimated 32,750 individuals with ice hockey-related injuries were treated in US EDs in 2001-2002, including >18,000 youths <18 years old. The number of injuries peak through adolescence (ages 12-17; 47% of all injuries). Males experienced 90% of all injuries. A very small percentage of individuals were hospitalized after injury (1.2% of individuals <18 years old; 0.5% of individuals > or =18 years old). The incidence of head injuries increased as age decreased, although the trend was not statistically significant. The upper extremity (44%) accounted for the highest total percentages of body regions injured for youths <18 years old, and trunk (14%) and facial injuries (10%) represented the smallest total percentages. Players > or =18 years old had significantly more lacerations than younger players (38% of injuries for 18- to 24-year-olds; 25% for 25- to 34-year-olds; 50% for 35- to 44-year-olds compared with 19% for 6- to 11-year-olds and 14% for 12- to 17-year-olds). CONCLUSIONS Adolescents had the greatest number of ice hockey-related injuries treated in NEISS hospital EDs in 2001-2002; thus, ongoing efforts to develop injury prevention strategies should focus on this age group. Players < or =17 years old had a lower percentage of lacerations compared with all older players and a higher percentage of upper extremity injuries. The percentage of individuals hospitalized after injury was very low, yet youths <18 years old had twice the percentage of hospitalization after injury compared with individuals > or =18 years old. Males experienced the vast majority of all ice hockey-related injuries, with females representing a higher percentage of injuries among youths than among adults. Children and adults alike can reap the physical fitness and social benefits from ice hockey, when they are able to avoid predictable and preventable injuries.
Collapse
Affiliation(s)
- Sarah Grim Hostetler
- Center for Injury Research and Policy, Columbus Children's Research Institute, Children's Hospital, Ohio State University, Columbus, Ohio 43205, USA
| | | | | |
Collapse
|
15
|
Cook DJ, Cusimano MD, Tator CH, Chipman ML. Evaluation of the ThinkFirst Canada, Smart Hockey, brain and spinal cord injury prevention video. Inj Prev 2004; 9:361-6. [PMID: 14693901 PMCID: PMC1731024 DOI: 10.1136/ip.9.4.361] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The ThinkFirst Canada Smart Hockey program is an educational injury prevention video that teaches the mechanisms, consequences, and prevention of brain and spinal cord injury in ice hockey. This study evaluates knowledge transfer and behavioural outcomes in 11-12 year old hockey players who viewed the video. DESIGN Randomized controlled design. SETTING Greater Toronto Minor Hockey League, Toronto Ontario. SUBJECTS Minor, competitive 11-12 year old male ice hockey players and hockey team coaches. INTERVENTIONS The Smart Hockey video was shown to experimental teams at mid-season. An interview was conducted with coaches to understand reasons to accept or refuse the injury prevention video. MAIN OUTCOME MEASURES A test of concussion knowledge was administered before, immediately after, and three months after exposure to the video. The incidence of aggressive penalties was measured before and after viewing the video. RESULTS The number of causes and mechanisms of concussion named by players increased from 1.13 to 2.47 and from 0.67 to 1.22 respectively. This effect was maintained at three months. There was no significant change in control teams. There was no significant change in total penalties after video exposure; however, specific body checking related penalties were significantly reduced in the experimental group. CONCLUSION This study showed some improvements in knowledge and behaviours after a single viewing of a video; however, these findings require confirmation with a larger sample to understand the sociobehavioural aspects of sport that determine the effectiveness and acceptance of injury prevention interventions.
Collapse
Affiliation(s)
- D J Cook
- Injury Prevention Research Office, St Michael's Hospital, Division of Neurosurgery, Toronto, Canada
| | | | | | | |
Collapse
|
16
|
Benson BW, Rose MS, Meeuwisse WH. The impact of face shield use on concussions in ice hockey: a multivariate analysis. Br J Sports Med 2002; 36:27-32. [PMID: 11867489 PMCID: PMC1724466 DOI: 10.1136/bjsm.36.1.27] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To identify specific risk factors for concussion severity among ice hockey players wearing full face shields compared with half face shields (visors). METHODS A prospective cohort study was conducted during one varsity hockey season (1997-1998) with 642 male ice hockey players (median age 22 years) from 22 teams participating in the Canadian Inter-University Athletics Union. Half of the teams wore full face shields, and half wore half shields (visors) for every practice and game throughout the season. Team therapists and doctors recorded on structured forms daily injury, participation, and information on face shield use for each athlete. The main outcome measure was any traumatic brain injury requiring assessment or treatment by a team therapist or doctor, categorised by time lost from subsequent participation and compared by type of face shield worn. RESULTS Players who wore half face shields missed significantly more practices and games per concussion (2.4 times) than players who wore full face shields (4.07 sessions (95% confidence interval (CI) 3.48 to 4.74) v 1.71 sessions (95% CI 1.32 to 2.18) respectively). Significantly more playing time was lost by players wearing half shields during practices and games, and did not depend on whether the athletes were forwards or defence, rookies or veterans, or whether the concussions were new or recurrent. In addition, players who wore half face shields and no mouthguards at the time of concussion missed significantly more playing time (5.57 sessions per concussion; 95% CI 4.40 to 6.95) than players who wore half shields and mouthguards (2.76 sessions per concussion; 95% CI 2.14 to 3.55). Players who wore full face shields and mouthguards at the time of concussion lost no playing time compared with 1.80 sessions lost per concussion (95% CI 1.38 to 2.34) for players wearing full face shields and no mouthguards. CONCLUSIONS The use of a full face shield compared with half face shield by intercollegiate ice hockey players significantly reduced the playing time lost because of concussion, suggesting that concussion severity may be reduced by the use of a full face shield.
Collapse
Affiliation(s)
- B W Benson
- Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | | |
Collapse
|
17
|
Waller AE, Feehan M, Marshall SW, Chalmers DJ. The New Zealand Rugby Injury and Performance Project: I. Design and methodology of a prospective follow-up study. Br J Sports Med 1994; 28:223-8. [PMID: 7894951 PMCID: PMC1332080 DOI: 10.1136/bjsm.28.4.223] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Injury resulting from participation in sporting and physical recreational activities is a major contributor to the overall incidence of injury in the developed world. If sports injuries are to be reduced, a comprehensive approach must be taken to define the nature and magnitude of the problem, to establish models of relationships between risk factors, protective factors and injury experience, and to address injury through well designed intervention and evaluation programmes. The Rugby Injury and Performance Project (RIPP) is a prospective cohort study designed to examine the risk and protective factors for rugby injury. Data were collected on potential risk and protective factors from the RIPP cohort pre-season. Data on exposure to rugby, injury events and medical treatments were collected from the players each week during the season through telephone interviews. Pre-season measures were repeated post-season. A key feature of the design was that data were collected on both injured and non-injured players, allowing a longitudinal comparison of the injury experience of players with and without the factors of interest. A wealth of information was collected on each cohort member during the pre-season interview. A contact rate of 90% was achieved during the weekly follow-up phase. Post-season questionnaires were completed by 76% of the players and 88% of the coaches. Recommendations are made for the use of this methodology by other researchers and future directions for RIPP are described.
Collapse
Affiliation(s)
- A E Waller
- Injury Prevention Research Unit, University of Otago, Dunedin, New Zealand
| | | | | | | |
Collapse
|