Contact allergy in Swedish professional ice hockey players

BACKGROUND

Professional ice hockey players may contract irritant and allergic contact dermatitis.

AIMS

To investigate the presence of contact allergy (CA) in professional ice hockey players in Sweden.

METHODS

Ten teams from the two top leagues were assessed for potential occupational exposure to sensitizers. Exactly 107 players were patch tested with an extended baseline series and a working series, in total 74 test preparations. The CA rates were compared between the ice hockey players and controls from the general population and dermatitis patients.

RESULTS

One out of 4 players had at least one contact allergy. The most common sensitizers were Amerchol L 101, nickel and oxidized limonene. CA was as common in the ice hockey players as in dermatitis patients and significantly more common than in the general population. Fragrances and combined sensitizers in cosmetic products (fragrances + preservatives + emulsifier) were significantly more common in ice hockey players compared with the general population.

CONCLUSION

The possible relationship between CA to fragrances and cosmetic products on the one hand and the presence of dermatitis on the other should be explored further.

Genotypic and Allelic Distribution of the CD36 rs1761667 Polymorphism in High-Level Moroccan Athletes: A Pilot Study

Previous studies have shown that variations in the CD36 gene may affect phenotypes associated with fat metabolism as the CD36 protein facilitates the transport of fatty acids to the mitochondria for oxidation. However, no previous study has tested whether variations in the CD36 gene are associated with sports performance. We investigated the genotypic and allelic distribution of the single-nucleotide polymorphism (SNP) rs1761667 in the CD36 gene in elite Moroccan athletes (cyclists and hockey players) in comparison with healthy non-athletes of the same ethnic origin. Forty-three Moroccan elite male athletes (nineteen cyclists and twenty-four field hockey players) belonging to the national teams of their respective sports (athlete group) were compared to twenty-eight healthy, active, male university students (control group). Genotyping of the CD36 rs1761667 (G>A) SNP was performed via polymerase chain reaction (PCR) and Sanger sequencing. A chi-square (χ2) test was used to assess the Hardy-Weinberg equilibrium (HWE) and to compare allele and genotype frequencies in the "athlete" and "control" groups. The genotypic distribution of the CD36 rs1761667 polymorphism was similar in elite athletes (AA: 23.81, AG: 59.52, and GG: 16.67%) and controls (AA: 19.23, AG: 69.23, and GG: 11.54%; χ2 = 0.67, p = 0.71). However, the genotypic distribution of the CD36 rs1761667 polymorphism was different between cyclists (AA: 0.00, AG: 72.22, and GG: 27.78%) and hockey players (AA: 41.67, AG: 50.00, and GG: 8.33%; χ2 = 10.69, p = 0.004). Specifically, the frequency of the AA genotype was significantly lower in cyclists than in hockey players (p = 0.02). In terms of allele frequency, a significant difference was found between cyclists versus field hockey players (χ2 = 7.72, p = 0.005). Additionally, there was a predominance of the recessive model in cyclists over field hockey players (OR: 0.00, 95% CI: 0.00-0.35, p = 0.002). Our study shows a significant difference between cyclists and field hockey players in terms of the genotypic and allelic frequency of the SNP rs1761667 of the CD36 gene. This divergence suggests a probable association between genetic variations in the CD36 gene and the type of sport in elite Moroccan athletes.

In search for climate neutrality in ice hockey: A case of carbon footprint reduction in a Finnish professional team

Mitigation actions in all sectors of society, including sports, to limit global warming have become an increasingly hot topic in public discussions and sports management. However, so far, there has been a lack of understanding and practical examples of how these organizations, especially in team sports, can holistically assess and reduce their climate impacts to achieve carbon neutrality. This paper presents a carbon footprint assessment, implemented actions for GHG emission reduction, and offers the example of a professional Finnish ice hockey team that achieved carbon neutrality. The study is based on a life cycle assessment method. The Results show that the team's carbon footprint was reduced from 350 tCO2eq by more than 50% between seasons 2018-2019 and 2021-2022 in the assessed categories. The most GHG emission reductions were achieved in the team's and spectators' mobility and ice hall energy consumption. Furthermore, the team compensated for their remaining emissions to achieve carbon neutrality. Multiple possibilities for further GHG emission reductions were recognized. The majority of the GHG emissions were linked to the Scope 3 category, indicating that co-operation with partners and stakeholders was a key to success in attaining carbon neutrality. This paper also discusses the possible limitations and challenges that sport organizations face in assessing climate impacts and reducing GHG emissions, as well as the prospects of overcoming them. Since there are many opportunities for sports to contribute to climate change mitigation, relevant targets and actions to reduce GHG emissions should be integrated into all sport organizations' management.

Preseason Measures of Cervical Spine Function, Vestibulo-Ocular Reflex, Dynamic Balance, and Divided Attention in Youth Ice Hockey Players

OBJECTIVES: Report typical scores and examine preseason cervical spine, vestibulo-ocular reflex, dynamic balance, and divided attention measures in competitive youth ice hockey players aged 10 to 18 years with and without a previous concussion history. DESIGN: Cross-sectional secondary analysis. METHODS: The exposure of interest was self-reported history of concussion. The main outcomes were cervical spine measures (Cervical Flexor Endurance [CFE; seconds], Cervical Flexion-Rotation Test [normal/abnormal], Anterolateral Cervical Spine Strength [kilograms], Head Perturbation Test (/8), and Joint Position Error [JPE; centimeters]), vestibulo-ocular reflex (Dynamic Visual Acuity [logMAR], Head Thrust Test [Positive/Negative]), dynamic balance (Functional Gait Assessment [/30]) and divided attention (Walking While Talking Test [seconds]). Multivariable linear or logistic regression, adjusted for age-group, sex, level of play, and clustered by team, were used to assess potential differences by concussion history. RESULTS: We included data from 2311 participants in this study (87.2% male, 12.8% female, 39.0% reported a previous concussion). No differences by concussion history were found across any of the measures (P values range: 0.17-0.99). Measures of cervical spine function and divided attention differed by age group (eg, Median Left Anterolateral Cervical Spine Strength [kilograms] for males: U13 = 7.46, U15 = 9.10, U18 = 9.67). CONCLUSION: Clinical outcomes scores in youth ice hockey players did not differ by concussion history. Performance on cervical spine strength, CFE, and JPE test outcomes may improve with age, highlighting the importance of developmental considerations when interpreting test scores. J Orthop Sports Phys Ther 2024;54(3):1-11. Epub 30 November 2023. doi:10.2519/jospt.2023.11958.

Cross-Sectional Study of the Anthropometric Profile and Nutrient Status of Elite Female Ice Hockey Players: Differences by Play Position

Both the characteristics of ice hockey and the environmental conditions in which it is played affect the maintenance of the player's nutritional status and, therefore, their state of health and performance. The primary aim of this work was to examine the anthropometric profile, estimated energy expenditure, and macronutrient and micronutrient dietary intake of elite female ice hockey players by play position. As a secondary aim, their dietary intakes were compared with the recommendations. Hypotheses suggest variations in body composition based on ice hockey players' positions, with the expectation that these athletes may not align with energy and nutrient recommendations. Fifteen elite female ice hockey players were anthropometrically measured, basal metabolic rate and total energy expenditure were estimated, a 3-day, 24 h recall questionnaire was registered, and the results were compared with the recommended dietary intake for the Spanish population. Each player's position on the field requires an individualized physical and nutritional approach. There are no significant imbalances (p > 0.05) between energy and nutrient intake in relation to the Recommended Daily Intake (RDI); however, increasing the consumption of vegetables and seafood while reducing meat and fat intake would assist these athletes in maintaining a healthier energy balance, optimizing body composition, and aligning with nutritional parameters that are better suited to enhance physical performance.

Different Aspects of Physical Load in Small-Sided Field Hockey Games

ABSTRACT

Wilmes, E, de Ruiter, CJ, van Leeuwen, RR, Banning, LF, van der Laan, D, and Savelsbergh, GJP. Different aspects of physical load in small-sided field hockey games. J Strength Cond Res 38(2): e56-e61, 2024-Running volumes and acceleration/deceleration load are known to vary with different formats of small-sided games (SSGs) in field hockey. However, little is known about other aspects of the physical load. Therefore, the aim of this study was to gain a more thorough understanding of the total physical load in field hockey SSGs. To that end, 2 different SSGs (small: 5 vs. 5, ∼100 m 2 per player; large: 9 vs. 9, ∼200 m 2 per player) were performed by 16 female elite field hockey athletes. A range of external physical load metrics was obtained using a global navigational satellite system and 3 wearable inertial measurement units on the thighs and pelvis. These metrics included distances covered in different velocity ranges (walk, jog, run, and sprint), mean absolute acceleration/deceleration, Hip Load, and time spent in several physically demanding body postures. The effects of SSG format on these external physical load metrics were assessed using linear mixed models ( p < 0.05). Running volumes in various speed ranges were higher for the large SSG. By contrast, mean absolute acceleration/deceleration and time spent in several demanding body postures were higher for the small SSG. This study shows that changing the SSG format affects different aspects of physical load differently.

The impact of COVID-19 on national hockey league players' return to play

OBJECTIVE

Evaluate the on-ice performance and return to play (RTP) rate following COVID-19 for National Hockey League (NHL) players during the 2020-21 season.

METHODS

Players with COVID-19 during the abbreviated 2020-21 season were identified using publicly accessible online sources. Demographics and on-ice metrics were accessed using the NHL's online statistics website. The length of time, rate of RTP, and games missed due to COVID-19 were analyzed. Primary outcomes included average time on ice (TOI) per game (TOI/G), average TOI per shift (TOI/S), and points per game (PPG) compared at different timepoints including pre- and post-COVID-19.

RESULTS

A total of 73 players (47 forwards, 18 defensemen, 8 goalies) had a documented COVID-19 diagnosis during the abbreviated 2020-21 season. Players missed an average of 5.6 games (14.7 days) due to COVID-19. The post-COVID-19 RTP rate was 97.3%, including playoffs. No differences were found in TOI/G between the pre- (15.7 ± 3.9 min) and post-COVID-19 (15.8 ± 3.4 min, p = 0.874) or in the first (15.8 ± 4.0 min) and second week (15.9 ± 3.8 min, p = 0.925) returned. TOI/shift did not change from pre- (45.6 ± 5.3 sec) to post-COVID-19 (46.7 ± 4.6 sec, p = 0.035) or in first (46.2 ± 5.4 sec) and second week post-COVID-19 (46.2 ± 4.8 sec, p = .854). No differences were identified for PPG between career, pre-COVID-19, and post-COVID-19 (0.44 vs 0.38 vs 0.41; p = 0.274).

CONCLUSION

RTP post-COVID was markedly high for NHL players. While the effects of COVID-19 on specific physiological measures remains to be elucidated, this study found NHL players do not have reduced performance following COVID-19.

Catastrophic Sports Injuries: Causation and Prevention

➤ Catastrophic injuries in U.S. high school and college athletes are rare but devastating injuries.➤ Catastrophic sports injuries are classified as either traumatic, caused by direct contact during sports participation, or nontraumatic, associated with exertion while participating in a sport.➤ Football is associated with the greatest number of traumatic and nontraumatic catastrophic injuries for male athletes, whereas cheerleading has the highest number of traumatic catastrophic injuries and basketball has the highest number of nontraumatic catastrophic injuries for female athletes.➤ The incidence of traumatic catastrophic injuries for all sports has declined over the past 40 years, due to effective rule changes, especially in football, pole-vaulting, cheerleading, ice hockey, and rugby. Further research is necessary to reduce the incidence of structural brain injury in contact sports such as football.➤ The incidence of nontraumatic catastrophic injuries has increased over the last 40 years and requires additional research and preventive measures. Avoiding overexertion during training, confirming sickle cell trait status in high school athletes during the preparticipation physical examination, and developing cost-effective screening tools for cardiac abnormalities are critical next steps.

Prevalence of lower limb pain and disability in football, hockey, and floorball players

BACKGROUND

Currently there are not enough studies that compared frequent types of collective sports with regard to the prevalence of pain and disability of the lower limb.

OBJECTIVE

To determine the prevalence of lower limb pain and disability in team sports players.

METHODS

388 athletes with average age 27.26 ± 4.69, from sports clubs at the national level were included in the study. The Oxford Hip Score was used to determine the prevalence of hip pain. The International Knee Documentation Committee was used to determine the prevalence of knee pain. The Foot and Ankle Disability Index was used to determine the prevalence of ankle pain.

RESULTS

Hockey players had a prevalence of hip pain of 97.2% and a 14.3 times higher risk of developing hip pain compared with football and floorball players. Floorball players had a 81.9% prevalence of knee pain, with a 3.8 times higher the risk of knee pain compared with football and hockey. Floorball players had a 62.3% prevalence of ankle pain and a 1.8 times higher the risk of developing ankle pain compared with football and hockey players.

CONCLUSIONS

The highest percentage of knee 81.9% and ankle 62.3% pain, as well as the greatest risk of pain, was found among floorball players. Hockey players had the highest prevalence (97.2%) and risk of developing hip pain.

Development of the Stressors among Parents in Youth Sport Survey (SPYSS)

OBJECTIVES

Parents of youth sport athletes report a variety of stressors associated with their child's participation in youth sport settings. However, research examining associations between parents' stressors and relevant outcomes is limited due to the lack of a comprehensive and validated measure of parents' stressors in youth sport. Therefore, the purpose of this research was to develop and provide preliminary validation of the Stressors among Parents in Youth Sport Survey (SPYSS).

METHOD

In Study 1 we developed an initial version of the survey and tested the factor structure of the scale using exploratory and confirmatory factor analyses with a sample of 1187 Canadian parents of minor hockey athletes. In Study 2, we administered the SPYSS to an independent sample of 783 parents with children participating in multiple sports, who also completed measures of parent stress and well-being, as well as parent-athlete outcomes, to establish convergent and divergent validity evidence and test associations with relevant outcomes for youth sport parents.

RESULTS

The results from Study 1 supported the development of a 42-item survey of parental stressors in youth sport. Results from Study 2 provided further evidence for the factor structure and validity evidence of a measure assessing parental stressors in youth sport.

CONCLUSIONS

The SPYSS assesses the frequency and intensity of a variety of stressors relevant for parents of youth sport athletes. The measure may be a useful tool for researchers, sport organizations, and practitioners to assess, monitor, and target the stressors experienced by parents in youth sport settings.

Changes in Body Composition and Athletic Performance in National Collegiate Athletic Association Division I Female Field Hockey Athletes Throughout a Competitive Season

ABSTRACT

Summer, LC, Cheng, R, Moran, JT, Lee, M, Belanger, AJ, TaylorIV, WL, and Gardner, EC. Changes in body composition and athletic performance in National Collegiate Athletic Association Division I female field hockey athletes throughout a competitive season. J Strength Cond Res 38(1): 146-152, 2024-The purposes of this study were (a) to analyze the changes in total and regional body composition measurements in a National Collegiate Athletic Association (NCAA) Division I female field hockey team throughout a 17-game competitive season using dual X-ray absorptiometry (DXA); (b) to examine improvements, if any, in athletic performance measures after a season; and (c) to report on the relationship between these body composition changes and changes in athletic performance. Preseason and postseason dual-energy DXA and performance data from the 2019-2020 season were retrospectively identified for 20 field players (forwards, midfielders, and defenders). Body composition data included total and regional fat mass, lean mass, and body fat percentage, whereas athletic performance measures included the vertical jump, 10-yard dash, and pro-agility (5-10-5) shuttle run. All variables were quantitative and analyzed using paired t -tests or its nonparametric equivalent and an alpha level of p < 0.05 was used to determine significance. After a competitive season, athletes had significant decreases in fat mass and increases in lean mass in their arms, legs, trunks, gynoids, and total body measurements. Android fat mass and body fat percentage also decreased. Athletes performed significantly better on the pro-agility shuttle run at the end of the season, but no significant differences were observed in other performance metrics. Moderate correlations were observed between changes in body composition (total fat mass and total lean mass) and changes in athletic performance. Our study provides a novel, longitudinal assessment of body composition and athletic performance for elite female field hockey athletes that will help trainers and coaches better understand how these variables change throughout a season and allow them to better prepare their players for competitive success.

On-field instrumented mouthguard coupling

Instrumented mouthguard (iMG) sensors have been developed to measure sports head acceleration events (HAE) in brain injury research. Laboratory validation studies show that effective coupling of iMGs with the human skull is crucial for accurate head kinematics measurements. However, iMG-skull coupling has not been investigated in on-field sports settings. The objective of this study was to assess on-field iMG coupling using infrared proximity sensing and to investigate coupling effects on kinematics signal characteristics. Forty-two university-level men's ice hockey (n = 21) and women's rugby (n = 21) athletes participated in the study, wearing iMGs during 6-7 month in-season periods. Proximity data classified video-verified HAE recordings into four main iMG coupling categories: coupled (on-teeth), decoupling (on-teeth to off-teeth), recoupling (off-teeth to on-teeth) and decoupled (off-teeth). Poorly-coupled HAEs showed significantly higher peak angular acceleration amplitudes and greater signal power in medium-high frequency bands compared with well-coupled HAEs, indicating potential iMG movements independent of the skull. Further, even video-verified true positives included poorly-coupled HAEs, and iMG coupling patterns varied between the men's hockey and women's rugby teams. Our findings show the potential of using proximity sensing in iMGs to identify poorly-coupled HAEs. Utilizing this data screening process in conjunction with video review may mitigate a key source of sensor noise and enhance the overall quality of on-field sports HAE datasets.

The Hockey Stick

This essay describes the author’s experience in interacting with a patient diagnosed with a serious illness and how focusing on the patient’s interests and making them happy was an example of a low-tech, high-touch intervention.

Body Weight Satisfaction, Comments, Nutrition and Injury Risk in 489 Adolescent Elite Athletes

Exposure to critical body weight comments in youth athletes could lead to decreased self-esteem, affect body image, and increase the risk of eating disorders and cause depressive symptoms. The aim was to explore differences between sex, body mass index, sports type, with regards to body weight satisfaction, exposure to critical body weight comments from their coach and nutrition status in adolescent elite athletes. A questionnaire about body weight, critical body weight comments and nutrition was distributed to 489 adolescent elite athletes and injury prevalence was monitored across 20 weeks. The results showed that almost one in four athletes (n=116, 24%) was not satisfied with their weight and 12% (n=59) had received critical body weight comments from their coach. Of the athletes who were unsatisfied with their body weight (n=116), 47% wanted to lose weight (n=55). A significant (p<0.05) higher proportion of ice hockey players and swimmers used nutritional supplements, were unsatisfied with their body weight, and were more exposed to critical body weight comments compared to athletes from other sports. Adolescent elite athletes as young as 15-16 years old are exposed to critical body weight comments from their coach and experience challenges with body weight satisfaction that is partly dependent on the sport-specific context.

The Relationship Between Lower-Body Force-Time Variables and Skating Performance in Female Ice Hockey Players

PURPOSE

Ice hockey is a team invasion sport characterized by repeated high-intensity skating efforts, technical and tactical skill, physical contact, and collisions requiring considerable levels of muscular strength. The purpose of this study was to evaluate the relationships between lower-body vertical force-time metrics and skating qualities in subelite female ice hockey players.

METHODS

A cross-sectional cohort design was employed utilizing 14 athletes (body mass = 66.7 [1.8] kg; height = 171.6 [6.2] cm; age = 21.1 [1.7] y). The relationships between metrics of lower-body strength collected from a drop jump, squat jump, countermovement jump, loaded countermovement jump, and an isometric squat and 4 skating qualities collected from a linear sprint, repeated sprint test, and a multistage aerobic test were evaluated.

RESULTS

The regression models revealed a positive relationship between relative peak force in the isometric squat and skating multistage aerobic test performance (r2 = .388; P = .017) and a positive relationship between repeated-sprint ability and eccentric mean force during the loaded countermovement jump (r2 = .595; P = .001). No significant relationships were observed between strength metrics and skating acceleration or maximal velocity.

CONCLUSIONS

These data suggest that skating ability is most affected by relative isometric strength in female ice hockey players. It is recommended that practitioners focus training on tasks that improve relative force output. It is also recommended that isometric relative peak force be used as a monitoring metric for this cohort.

Characterization of pincer-type Hip impingement in professional women's ice hockey players

OBJECTIVE

Femoroacetabular impingement (FAI) appears common in ice hockey, but there is a lack of data examining pincer-type impingement in women's ice hockey athletes. The objective of this study was to assess the prevalence of pincer-type impingement in National Women's Hockey League (NWHL) athletes. Our hypothesis was that there would be an increased prevalence of pincer impingement in these athletes.

METHODS

Data were gathered for a team of NWHL players, and age, gender, and body mass index (BMI) matched controls were also retrospectively collected. All subjects were above 18 years of age. Control patients were excluded if they had undergone prior hip surgery, were greater than age 30, or had BMI greater than 35. Radiographs of both groups were assessed for lateral center edge angle (LCEA), Tönnis angle, and crossover sign. Tönnis angle <0 or LCEA >40 degrees was considered pincer morphology. An alpha angle >55 degrees was considered cam morphology.

RESULTS

Thirty-seven NWHL players and 37 female controls were included. Overall 32% of the players had a pincer lesion in either hip based on LCEA, 8% had a Tönnis angle <0, and 22% had a crossover sign in either hip compared to 9%, 19%, and 13% for the controls, respectively. None of these findings were significantly different between the groups (p > 0.05). An alpha angle ≥55 degrees in either hip was found in 84% of players, but lateral Dunn images for alpha angle measurements were not available for the control group.

CONCLUSIONS

Pincer-type morphology and crossover signs were present in a larger portion of NWHL players than has been reported in the general population, but these findings were not statistically different than in the control group. Cam-type morphology was even more prevalent in these athletes and may be related to age at menarche due impingement at the physis prior to closure.

Contemporary Practices of Strength and Conditioning Coaches in High-Level Male Ice Hockey: A Survey-Based Investigation

ABSTRACT

Galati, D, Turner, AN, Bishop, C, and Maloney, SJ. Contemporary practices of strength and conditioning coaches in high-level male ice hockey: a survey-based investigation. J Strength Cond Res 37(11): 2241-2250, 2023-The aim of this study was to provide an updated view of the common practices, ideologies, education level, and professional environment of strength and conditioning (S&C) coaches in elite male ice hockey. Nineteen S&C coaches from professional, semiprofessional, and top-tier collegiate hockey teams in North America completed an anonymous online survey. This was composed of 10 sections: (a) background information; (b) technology use, (c) testing and periodization, (d) strength and power, (e) flexibility/mobility, (f) speed, (g) plyometrics, (h) aerobic and anaerobic conditioning, (i) rehabilitation, and (j) challenges and areas of improvement. Fixed-response questions were analyzed through frequency analyses. Thematic analyses were used to identify common themes from open-response questions. Strength and conditioning coaches had an average of 8 (±6.5) years of experience when they accepted their current role. The majority held a master's degree and S&C certification. Muscular power, linear speed, and body composition were the most frequently tested qualities. Neuromuscular fatigue was the most important consideration during the season and least important consideration during the off-season. Training frequencies for all physical capacities were lower during the season compared with the off-season. All S&Cs had access to technology, with wearables, with force plates identified as the most used devices. This information may be used by S&C coaches to compare working practices with those used by their peers and inform them of the likely requirements and skill sets needed for job applications. Educational institutions may use this information to align teaching to current practice and to inform future research.

Reinvestment in one versus one in-field and shoot-out field hockey performance

The theory of reinvestment suggests that inappropriate use of attention to consciously engage in movements or decisions (movement specific reinvestment or decision specific reinvestment) can result in disrupted performance. We used moderation analysis to investigate the association between these forms of reinvestment and performance during one versus one in-field and shoot-out scenarios during field hockey. We expected that the propensity for reinvestment would be negatively associated with shoot-out performance but not in-field performance, because monitoring many other players during in-field play diverts attention away from conscious engagement in movements or decisions. No association was evident between decision specific reinvestment and in-field or shoot-out performance. However, a higher propensity for movement specific reinvestment (specifically, conscious motor processing) was negatively associated with shoot-out performance, but not in-field performance. We speculate that the necessity to shift between many non-static attentional demands during in-field situations may reduce capacity for movement specific reinvestment during performance.

New training load metrics in field hockey using inertial measurement units

Field hockey players are exposed to high biomechanical loads. These loads often cannot be adequately estimated with global navigational satellite systems (GNSS) since on-field displacements during these movements are often small. Therefore, this study aims to explore the potential of different proxies of biomechanical load in field hockey with use of a simple inertial measurement unit (IMU) system. Sixteen field hockey players performed a range of field hockey specific exercises, including running with stick on the ground, running upright, and different types of shots and passes. All exercises were performed at two different frequencies (i.e. number of actions per minute). A variety of proxies of biomechanical load (time spent with forward tilted pelvis, time spent in lunge position, time spent with flexed thighs, and Hip Load) were obtained using wearable IMUs. In addition, total distance was quantified using a GNSS system. Linear mixed models were constructed to determine the effects of the different exercises and action frequency on all quantified metrics. All metrics increased approximately proportional to the increase in action frequency. Total distance and Hip Load were greatest for the running exercises, but the different types of shots and passes had greater effects on specific on the times spent in the demanding body postures. This shows that these proxies of biomechanical load can be used to estimate field hockey-specific biomechanical loads. The use of these metrics may provide coaches and medical staff with a more complete view of the training load that field hockey players experience.Highlights New proxies of biomechanical load derived with inertial measurement units were used to quantify field hockey specific biomechanical loads.These new biomechanical metrics are complementary to metrics obtained with global navigation satellite systems and increased proportionally to a doubling of the exercise intensity.The presented biomechanical load metrics can help field hockey coaches to achieve a better balance between load and recovery for their players.

When hockey parents are motivationally imbalanced: Passion, need satisfaction, and verbal aggression toward officials

Spectators can engage in high levels of verbal aggression toward youth hockey officials. Often, the perpetrators of this aggression are the parents. Our aim was to test the motivational factors involved in explaining why hockey parents sometimes take things too far and engage in verbally aggressive behavior toward officials. We reasoned that verbal aggression toward officials would be a function of two forms of motivational imbalance. First, in line with the dualistic model of passion, we hypothesized that verbal aggression would be positively associated with hockey parents' obsessive passion, an imbalanced form of passion. Also, based on the compensatory model of passion, we predicted that obsessive passion would be associated with imbalanced psychological need satisfaction involving high need satisfaction from being a hockey parent, but low global need satisfaction. We administered online surveys to Canadian hockey parents (N = 992) assessing their verbal aggression toward officials, passion for being a hockey parent, and psychological need satisfaction from being a hockey parent and in general. Using structural equation modeling, we found support for a model in which high need satisfaction from being a hockey parent and low need satisfaction in general were associated with obsessive passion. Obsessive passion, in turn, was associated with greater verbal aggression toward referees. These findings help reveal why some hockey parents insult, threaten, and engage in other forms of verbal aggression toward officials. They also highlight the importance of maintaining motivational balance among sport parents.

Concussion Characteristics in the National Hockey League Before and After the Introduction of Rule 48

Importance

A rule prohibiting a direct hit to the lateral side of the head (ie, Rule 48-Illegal Check to the Head) was introduced in the National Hockey League (NHL) in the 2010-2011 season and refined in the 2011-2012 season to widen the application to include direct contact to all areas of the head.

Objective

To compare the incidence and proportion of concussions that occurred following hits to the head before and after the implementation of Rule 48.

Design, Setting, and Participants

This retrospective cohort study used a before and after design to evaluate concussions among NHL players in regular season games. Data from the 4 seasons preceding the implementation of Rule 48 (2006-2007 to 2009-2010) were compared with data from 5 seasons following its implementation (2014-2015 to 2018-2019). Data were analyzed from October 31, 2021, to November 30, 2022.

Main Outcomes and Measures

The incidence and relative proportion of concussion characteristics and mechanisms before and after the introduction of Rule 48.

Results

In the analysis of 688 concussions for NHL seasons spanning 2006 to 2010 (n = 231) and 2014 to 2019 (n = 457), there was an overall increase in the incidence of concussion between the 2 time frames, although the incidence of concussions due to hits to the lateral aspect of the head decreased from 1.6/100 games to 1.0/100 games (estimated difference, 0.6/100 games [90% credible interval (CrI), 0.30/100 games to 0.90/100 games). There was also a reduction of 18.8 (90% CrI, 13.0-23.7) percentage points in the proportion of concussions due to hits to the lateral aspect of the head from 80 of 231 concussions (34.6%) to 61 of 457 concussions (13.3%). The incidence of concussions following hits to the head from body checks using the shoulder, arm, and glove was similar before and following the implementation of Rule 48. However, the proportion was reduced 14.7 percentage points from 113 of 231 concussions (48.9%) before to 149 of 457 concussions (32.6%) after implementation of Rule 48 (90% CrI of the difference, 8.9-20.7 percentage points).

Conclusions and Relevance

The findings of this cohort study of NHL players suggest that after the introduction of Rule 48, the incidence rate and proportion of concussions from contact to the lateral aspect of the head decreased, as did the proportion of concussions following direct hits to the head.

And the award goes to…the Matthew Effect: Examining external status as a predictor of productivity and opportunity

It has been suggested that increased status that comes from being an award winner can generate enduring advantages that compound over one's career via the Matthew Effect. However, research in this area has yielded conflicting results and has been unable to isolate the unique effect of status on career outcomes from the positive endogenous characteristics of award winners. In the current research, we attempt to address previous research limitations and examine if winning an award is associated with career outcomes (i.e., opportunities and productivity) irrespective of individual productivity levels prior to receiving an award. We examined our research questions using observational data of National Hockey League (NHL) league championship winners and non-winners (N = 427). By using a team award and several different analytic approaches we were able to examine the unique effects of affiliation-based external status, generated from an award win, on career outcomes. Our results generally show support for the Matthew Effect and suggest that affiliation-based external status, achieved by an award win, provides access to increased opportunities, which ultimately results in more productivity. We discuss the importance of incorporating opportunity and investigating its role in the cumulative advantage process and implications of the results.

Associations between the circumstances and severity of head impacts in men's university ice hockey

Improved evidence on the most common and severe types of head impacts in ice hockey can guide efforts to preserve brain health through improvements in protective gear, rink design, player training, and rules of play. In this observational cohort study of men's university hockey, we compared video evidence on the circumstances of 234 head impacts to measures of head impact severity (peak linear accelerations and rotational velocities) from helmet-mounted sensors (GForceTracker). Videos were analyzed with a validated questionnaire, and paired with helmet sensor data. Shoulder-to-head impacts were more common than hand- or elbow-, but there were no differences in head impact severity between upper limb contact sites (p ≥ 0.2). Head-to-glass impacts were nearly four times more common, and just as severe as head-to-board impacts (p ≥ 0.4). Head impacts resulting in major penalties (versus no penalty), or visible signs of concussion (versus no signs), involved greater head rotational velocities (p = 0.038 and 0.049, respectively). Head impacts occurred most often to the side of the head, along the boards to players in their offensive zone without puck possession. Head impact severity did not differ between cases where the head was (versus was not) the primary site of contact (p ≥ 0.6). Furthermore, penalties were called in only 4% of cases where the head was the initial point of contact. Accordingly, rules that focus on primary targeting of the head, while important and in need of improved enforcement, offer a limited solution.

Femoroacetabular Impingement in Ice Hockey Athletes

ABSTRACT

Femoroacetabular impingement (FAI) in ice hockey is a concern for many athletes. The biomechanics of skating and the injury mechanism, prevalence, identification, and treatment protocols currently available for FAI in ice hockey athletes are important for all coaches and practitioners to understand. This article discusses the underlying anatomical issues and biomechanical considerations surrounding FAI. Furthermore, this article describes the interventions that can be used when encountering FAI and well-established protocols to aid in the return to play. Finally, prevention strategies that can aid in injury prevention are discussed.

Differences in inter-segment coordination between high- and low-calibre ice hockey players during forward skating

The objective was to compare lower extremity inter-segment coordination between high-calibre and low-calibre ice hockey players during forward full stride skating. A 10-camera Vicon motion capture system collected kinematic data on male high-calibre (n = 8) and low-calibre (n = 8) participants. Continuous relative phase (CRP) was calculated for shank-sagittal/thigh-sagittal, shank-sagittal/thigh-frontal and foot-sagittal/shank-sagittal segment pairs. Principal component analysis (PCA) was used to extract features of greatest variability of the CRP and hierarchical linear model investigated relationships between principal components and skill level. High-calibre players demonstrated more out-of-phase coordination (higher CRP) of shank-sagittal/thigh-sagittal throughout glide/push-off (p = 0.011) as well as a delay in the transition to more in-phase coordination during early recovery phase (p = 0.014). For shank-sagittal/thigh-frontal (p = 0.013), high-calibre players had more out-of-phase coordination throughout the entire stride. High-calibre players were also associated with an earlier transition to more out-of-phase coordination of the foot-sagittal/shank-sagittal during push-off (p = 0.007) and a smaller difference in CRP between mid-glide/early recovery (p = 0.016). Utilising more out-of-phase modes of coordination may allow players to more easily adjust to optimal modes of coordination throughout skating strides. Skating drills incorporating varying speed, directionality and external stimuli may encourage the development of more optimal coordination during skating.

Comparative Risk Analysis of Low Back Pain among Professional Football, Ice Hockey, and Floorball Athletes

BACKGROUND Low back pain (LBP) is a common concern among professional athletes, potentially hindering performance and career longevity. However, comparative assessments of LBP prevalence and severity across various sports remain scarce. This study aimed to evaluate the factors associated with LBP in 388 professional athletes, including football, ice hockey, and floorball players. MATERIAL AND METHODS Conducted from June 2021 to September 2022, this cross-sectional study incorporated 388 athletes from national elite clubs, including football (n=148), ice hockey (n=179), and floorball (n=61). The Oswestry Disability Index (ODI), comprising sections like pain intensity, self-care, lifting, walking, sitting, standing, sleeping, sexual life, social life, and traveling, was employed to evaluate spinal pain and disability. RESULTS The study found no significant disparities in the LBP assessment among the groups. The relative risk (OR) of LBP and disability varied among the sports: football players displayed a lower risk (OR=0.49; 95% CI 0.32-0.74, P≤0.001), while ice hockey players had a higher risk (OR=2.18; 95% CI 1.45-3.29, P≤0.001) compared to the others. In contrast, the risk for floorball players (OR=0.82; 95% CI 0.47-1.41) did not significantly deviate from that of the other two sports. CONCLUSIONS LBP prevalence stood at 42.6% for football players, 60.1% for ice hockey players, and 49.2% for floorball players. Among these, ice hockey players exhibited a 2.18-fold increased risk of developing LBP and associated disability when compared to their football and floorball counterparts.

Mechanical Determinants of Sprinting and Change of Direction in Elite Female Field Hockey Players

Profile determination in field hockey is critical to determining athletes' physical strengths and weaknesses, and is key in planning, programming, and monitoring training. This study pursued two primary objectives: (i) to provide descriptive data on sprinting, deceleration, and change of direction (COD) abilities and (ii) to elucidate the mechanical variables that influence sprint and COD performance in elite female field hockey players. Using radar and time-gate technology, we assessed performance and mechanical data from 30 m sprinting, deceleration, and COD tests for 26 elite female hockey players. A machine learning approach identified mechanical variables related to sprint and COD performance. Our findings offer a framework for athlete categorization and the design of performance-enhancing training strategies at the international level. Two pivotal mechanical variables-relative maximum horizontal force (F0) and maximum velocity (Vmax)-predominantly influence the times across all tested distances. However, the force-velocity profile (FVP) and horizontal deceleration do not influence the variance in the COD test outcomes. These insights can guide the design, adjustment, and monitoring of training programs, assisting coaches in decision making to optimize performance and mitigate injury risks for female hockey players.

Prevalence of symptoms of depression and generalized anxiety disorder in field hockey players of German first and lower leagues

BACKGROUND

While several studies on mental health of elite athletes were published in recent years, few compared the prevalence with the general population and none included field hockey players.

AIMS

To analyze the prevalence of symptoms of depression and generalized anxiety disorder in field hockey players of different skill levels and to compare it to the general population.

METHODS

Male and female hockey players from different leagues were asked to answer questions on player characteristics, the Centre of Epidemiologic Studies Depression Scale (CES-D) and the Generalized Anxiety Disorder-7 (GAD-7).

RESULTS

One hundred and eighty-seven players (incl. 54 first and 28 second league players) participated in the study (response rate 97.4%). More than a third (n = 64; 35.0%) reported to be affected by an injury/health complaint, but 157 (86.3%) were able to train and play without limitations. The CES-D score indicated depression symptoms in more female (n = 15; 18.3%) than male (n = 5; 4.8%) players (χ2=8.8; p < 0.01). No male and one female player had symptoms of generalized anxiety disorder. Players who played 60 or more matches in the previous 12 months had on average significantly higher depression (t = 2.3; p < 0.05) and generalized anxiety scores (t = 4.2; p < 0.001) than players who played fewer matches. The prevalence of depression and of generalized anxiety symptoms was similar to or lower than in the general population. Although 20 (10.7%) players had depression symptoms, only 4 (2.2%) received psychological counseling or psychotherapy.

CONCLUSION

It is recommended to provide routine screening of mental health problems and low-threshold access to adequate treatment for elite athletes.

Can Referees Assess Head Contact Penalties Correctly in Canadian Youth Ice Hockey? A Video Analysis Study

OBJECTIVE

To help address the high concussion burden in Canadian youth ice hockey, our primary objective was to examine the concurrent validity of youth ice hockey referees' ability to assess head contacts (HCs) and associated penalties using video analysis methods after implementation of the "zero tolerance for HC" policy by Hockey Canada.

STUDY DESIGN

Cross-sectional study.

PARTICIPANTS

Certified Level II-III referees in Alberta, Canada.

INTERVENTION

A secured online survey with 60 videos (10 to 15 seconds) containing a player-to-player physical contact with or without a HC from elite U15 (ages 13 to 14) youth ice hockey games.

OUTCOME MEASURES

Survey questions were completed by all referees for each video, including (1). 'Did you see a player-to-player contact?', (2). 'Should a penalty be assessed?', and if yes, (3). 'Which player, penalty type, and penalty intensity?' Referee assessments were compared with a consensus agreement from 2 national and member (top level) gold standard referees for concurrent validity through percent agreement and sensitivity/specificity measures.

RESULTS

Complete-case analysis of 100 referees (131 recruited) showed an overall median agreement of 83.5% (sensitivity = 0.74; specificity = 0.69) with the gold standard. Agreement with the gold standard was highest for HC infractions [85.1% (sensitivity = 0.80; specificity = 0.69)], followed by HC penalty type (81.5%) and penalty intensity (53.7%).

CONCLUSIONS

Concurrent validity through percent agreement was high (>80%) compared with the gold standard for identifying both HC and other infractions; however, it was moderate for penalty intensity. Although knowledge of identifying HCs and penalties in this survey was acceptable, this study suggests in-game factors (eg, game management and positioning) may be a primary limitation for HC enforcement.

Force-velocity profiling in ice hockey skating: reliability and validity of a simple, low-cost field method

In recent years, a simple method for force-velocity (F-v) profiling, based on split times, has emerged as a potential tool to examine mechanical variables underlying running sprint performance in field conditions. In this study, the reliability and concurrent validity of F-v profiling based on split times were examined when used for ice hockey skating. It was also tested how a modification of the method, in which the start instant of the sprint is estimated based on optimisation (time shift method), affects the reliability and validity of the method. Both intra- and inter-rater reliability were markedly improved when using the time shift method (approximately 50% decrease in the standard error of measurement). Moreover, the results calculated using the time shift method highly correlated (r > 0.83 for all variables) with the results calculated from a continuously tracked movement of the athlete, which was considered here as the reference method. This study shows that a modification to the previously published simple method for F-v profiling improves intra- and inter-rater reliability of the method in ice hockey skating. The time shift method tested here can be used as a reliable tool to test a player's physical performance characteristic underlying sprint performance in ice hockey skating.

Comparing Impact and Concussion Risk in Leatherhead and Modern Football and Hockey Helmets

BACKGROUND

Improvements in the modern helmet have demonstrated beneficial effects in reducing concussion risk in football players. However, previous studies yield conflicting results regarding the protective quality of leatherhead football helmets. There is limited research comparing the modern football helmet and the modern hockey helmet, with one previous study demonstrating the football helmet as providing a lower risk of concussion.

OBJECTIVE

To compare the head acceleration produced in a leatherhead football helmet vs a modern football helmet vs a modified modern football helmet with softer padding vs a modern hockey helmet in helmet-to-helmet strikes.

METHODS

Accelerometers were placed on the frontal, apex, and parietal regions of a Century Body Opponent Bag manikin. Each type of helmet was placed on the manikin and struck by a swinging modern football helmet. The G-force acceleration was determined in three-dimensional axes of 100 total helmet-to-helmet impacts.

RESULTS

The leatherhead football helmet was the least protective in reducing G-forces. The modified modern football helmet did not provide a significant difference compared with the modern football helmet. Significantly greater G-forces were produced in a collision between 2 modern football helmets in comparison with 2 modern hockey helmets.

CONCLUSION

The leatherhead football helmet was the least protective, and the hockey helmet was the most protective, with the football helmet being intermediate. This study provides additional insight into the inconclusive evidence regarding the safety of leatherhead football helmets and into the design of football and hockey helmets in the future.

Microdosing Sprint Distribution as an Alternative to Achieve Better Sprint Performance in Field Hockey Players

Introduction: The implementation of optimal sprint training volume is a relevant component of team sport performance. This study aimed to compare the efficiency and effectiveness of two different configurations of within-season training load distribution on sprint performance over 6 weeks. Methods: Twenty male professional FH players participated in the study. Players were conveniently assigned to two groups: the experimental group (MG; n = 11; applying the microdosing training methodology) and the control group (TG; n = 9; traditional training, with players being selected by the national team). Sprint performance was evaluated through 20 m sprint time (T20) m and horizontal force−velocity profile (HFVP) tests before (Pre) and after (Post) intervention. Both measurements were separated by a period of 6 weeks. The specific sprint training program was performed for each group (for vs. two weekly sessions for MG and TG, respectively) attempting to influence the full spectrum of the F-V relationship. Results: Conditional demands analysis (matches and training sessions) showed no significant differences between the groups during the intervention period (p > 0.05). No significant between-group differences were found at Pre or Post for any sprint-related performance (p > 0.05). Nevertheless, intra-group analysis revealed significant differences in F0, Pmax, RFmean at 10 m and every achieved time for distances ranging from 5 to 25 m for MG (p < 0.05). Such changes in mechanical capabilities and sprint performance were characterized by an increase in stride length and a decrease in stride frequency during the maximal velocity phase (p < 0.05). Conclusion: Implementing strategies such as microdosed training load distribution appears to be an effective and efficient alternative for sprint training in team sports such as hockey.

The distribution of different intensity demanding scenarios in elite rink hockey players using an electronic performance tracking system

Despite the traditional use of average values for determining physical demands, the intermittent and fluctuating nature of team sports may lead to underestimation of the most demanding scenarios. All the most demanding scenario-related investigations to date only report one maximal scenario per game, the greatest. However, the latest research on this subject has shown additional scenarios of equal or similar magnitude that most researchers have not considered. This repetition concept started a new way of describing competition and training loads; then the study aims were: first, to quantify and assess differences between playing positions in terms of the most demanding scenarios in official matches; and second, to quantify and assess the differences between playing positions in the repetition of different intensity scenarios relative to the most demanding individual scenario. We monitored nine professional rink hockey players (7 exterior and 2 interior players) in 18 competitive matches using an electronic performance tracking system. The interior players are closest to the opponent's goal, while the exterior players are farthest from it. Peak physical demands variables included total distance (m), distance covered at >18 km·h-1 (m), the number of accelerations (≥2 m∙s-2, count) and decelerations (≤-2 m∙s-2, count) in 30 s. An average from the top three individual most demanding scenarios was used to define a reference value to quantify the distribution scenario repetition during matches. The results showed that peak demands in rink hockey are position-dependent, with more distance covered by exterior players and more accelerations performed by interior players. In addition, rink hockey matches include multiple scenario exposures that are close to the peak physical demands of a match. Using the results of this study, coaches can prepare tailored training plans for each position, focusing on distances covered or accelerations for exterior players.

Influenza A Outbreaks in Two Professional Ice Hockey Teams during COVID-19 Epidemic

Influenza A outbreaks occurred in two professional hockey teams just after two games they played against each other. Thirteen players and two staff members fell ill during 17-20 April 2022, while COVID-19 was prevalent. Altogether, seven players missed an important game due to influenza. The rapid diagnosis permitted effective pharmaceutical and nonpharmaceutical control of the outbreaks.

[Traumatic brain injuries in winter sports : An overview based on the winter sports skiing, snowboarding and ice hockey]

In winter sports, skiers, snowboarders and ice hockey players have the highest risk of traumatic brain injuries (TBI). In skiing/snowboarding severe TBIs are of concern; in ice hockey, repetitive minor TBIs are frequent. The main causes of TBI in recreational skiing are collisions with trees; in professionals falls due to technical or tactical mistakes are the main causes. In ice hockey 10-15% of all injuries are due to a sports-related concussion (SRC), mostly caused by player-opponent contact. The pathomechanism in TBI is a combination of rotational and linear acceleration during head impact, which causes a diffuse axonal injury. Long-term complications such as neurodegenerative diseases and functional deficits are of relevance. Prevention by wearing helmets is effective, but less effective in TBI/SRC than in focal injuries.

Body Composition Asymmetries in University Ice Hockey Players and Their Implications for Lower Back Pain and Leg Injury

ABSTRACT

Resta, T, Frenette, S, Rizk, A, and Fortin, M. Body composition asymmetries in university ice hockey players and their implications for lower back pain and leg injury. J Strength Cond Res 36(10): 2830-2836, 2022-Right to left asymmetries in body composition have been examined across many sports, suggesting possible implications for lower back pain (LBP) and decreased level of performance. However, we are not aware of any study that has examined the presence and implications of morphological asymmetries in ice hockey players. The purpose of this study was to (a) investigate body composition asymmetries in female and male university-level ice hockey players and (b) examine whether the degree of body composition asymmetry is associated with the history of LBP and lower-limb injury (LLI). A total of 32 players (female = 18, male = 14) were included in this cross-sectional study (e.g., university research center setting). Dual-energy X-ray absorptiometry (DEXA) was used to acquire body composition measurements. The parameters of interest included bone mass, lean body mass, and fat mass, for the right and left sides and body segments (e.g., arm, leg, trunk, and total), separately. The history of LBP and LLI was obtained using a self-reported demographic questionnaire. The statistical significance for the study was set at p < 0.05. Our findings revealed significant side-to-side asymmetry in arm and total bone mass in females, with higher values on the right side. Both males and females also had significantly greater trunk lean body mass on the left side. With the exception of greater arm bone mass asymmetry being associated with LBP in the past 3 months, there was no other significant association between the degree of asymmetry with LBP and LLI. This study provides novel data regarding the presence of asymmetry in body composition in university-level ice hockey players. Monitoring body composition in athletes provides information that can be used by athletic trainers and strength and conditioning coaches to develop injury prevention, performance optimization, and targeted rehabilitation programs.

Float like a Butterfly: Comparison between Off and On-Ice Torso Kinematics during the Butterfly Stance in Ice Hockey Goalkeepers

In ice hockey, the butterfly style/stance is a technique distinguished by the goalkeepers (goalie) dropping to their knees to block attempts to score. Although this goalie style has been around for many years, comparisons between on and off-ice attire has not been undertaken. Therefore, this preliminary study compared differences in torso acceleration and energy expenditure by way of the Metabolic Equivalent of Task (MET) during off-ice and on-ice butterfly stances/saves. Seven participants each performed 8 on-ice butterfly saves/stances whilst wearing full hockey attire followed by 8 off-ice butterfly stances without wearing full hockey attire whilst torso acceleration was collected. The off-ice movement significantly increased vertical torso acceleration (p < 0.01, d > 0.90) with increased MET, compared to on-ice motion. Despite no significant difference in anteroposterior and mediolateral torso kinematics, vector magnitudes were significantly greater (p < 0.01, d > 0.90) when the stance was performed off-ice. The increased vertical acceleration observed when goalies performed the movement off-ice could be due to a failure to maintain adequate posture without the support of the external load. The results of this study may help inform off-ice training interventions for ice hockey goalkeeping.

Electrocardiographic Findings in Professional Male Athletes

OBJECTIVE

To generate granular normative electrocardiogram (ECG) data and characterize the variation by ethnicity and sport played.

DESIGN

Cross-sectional study; ECGs were collected from preseason screening programs from 2012 to 2019 and interpreted in accordance with athlete-specific guidelines.

SETTING

Of the professional athletes based in Vancouver, the North Shore Heart Centre performs the annual preparticipation ECG screening.

PARTICIPANTS

Seven hundred fifty-three professional male athletes competing in hockey, football, lacrosse, skiing, and snowboarding.

INTERVENTIONS

Independent variables include commonly transcribed electrocardiographic findings, for example, those indicating benign and pathologic findings.

MAIN OUTCOME MEASURES

Prevalence of and variance in electrocardiographic findings by sport played and ethnicity.

RESULTS

Of the 753 athletes, 171 (22.3%) were National Hockey League, 358 (47.5%) were Canadian Football League, 163 (21.6%) were Major League Soccer and/or the Canadian National Soccer team, and 61 (8%) others. The most common finding, sinus bradycardia, was more likely in both soccer (P < 0.001) and hockey (P < 0.001) versus football players. Early repolarization (ER) was more likely in soccer players versus both hockey (P < 0.001) and football players (P = 0.001). Within football, Black athletes (BA) were more likely than White athletes to display ER (P = 0.009), left ventricular hypertrophy (P = 0.004), and nonspecific ST changes (P = 0.027).

CONCLUSION

Our study contributes to the generation of normative data for ECG findings while accounting for ethnic and sport-specific variation. The expected clinical presentation of endurance athletes, including soccer players, and the possible predisposition of BA to develop distinct adaptations can augment clinical care by delineating physiology from pathologic changes.

Short-Term Neurologic Manifestations of Repetitive Head Impacts Among Athletes: A Scoping Review

OBJECTIVE

To summarize the evidence linking contact sports-related repetitive head impacts (RHIs) and short-term declines in neurologic function.

METHODS

A scoping review following the guidelines in the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and searching 3 databases (PubMed, EMBASE, and Web of Science) was performed. Peer-reviewed research articles were eligible for inclusion if they were full-length English language articles published between 1999 and 2019 examining athletes between the ages of 14 and 40 years exposed to RHIs, and reporting cognitive, vestibular, and/or oculomotor outcomes within 4 weeks of last head hit exposure.

RESULTS

Fifty-two articles met criteria for review: 14 reported oculomotor outcomes, 23 reported vestibular outcomes, and 36 reported cognitive function. Short-term RHI-related declines in neurologic function were reported in 42.9% of oculomotor studies, in 20.8% of vestibular studies, and in 33.3% of cognitive studies. Most of the 52 studies involved American football, soccer, or ice hockey athletes at the collegiate ( n = 23) or high school ( n = 14) level. Twenty-four (46%) studies involved only male athletes. Wearable sensors were used to measure RHIs in 24 studies (46%), while RHIs were not measured in 26 studies (50%). In addition, many studies failed to control for attention-deficit/hyperactivity disorder/learning disability and/or concussion history.

CONCLUSION

The results of this scoping review suggest that the evidence linking RHIs to short-term declines in neurologic function is relatively sparse and lacking in methodological rigor. Although most studies failed to find a link, those that did were more likely to use objective measures of RHIs and to control for confounders. More careful trial design may be needed to definitively establish a causal link between RHIs and short-term neurologic dysfunction.

Double Major for Slashing: Management of Blunt Popliteal Fossa Trauma in Ice Hockey in the Setting of Popliteal Artery Entrapment Syndrome

ABSTRACT

Popliteal artery entrapment syndrome (PAES) is a rare condition that produces calf claudication in young patients. It is most commonly a result of aberrant anatomy of the popliteal fossa. If undiagnosed, PAES can lead to acute ischemia and a threatened limb as a result of complete arterial occlusion or embolism. Ice hockey is a contact sport, and slashing on the covered legs is well described as a strategy and contact point. We present a unique case that highlights a blunt popliteal artery injury in a young player with an underlying type 2 PAES. We discuss the initial diagnosis and endovascular/vascular surgical treatment, followed by the delayed management of the popliteal artery injury. We also provide considerations for popliteal fossa blunt trauma and need for future protection of the popliteal fossa for athletes.

Effects of Short-Term Intake of Montmorency Tart Cherry Juice on Sleep Quality after Intermittent Exercise in Elite Female Field Hockey Players: A Randomized Controlled Trial

The purpose of this study was to investigate the effect of short-term consumption of tart cherry juice on levels of cortisol and melatonin and sleep quality after intermittent exhaustion exercise in female elite field hockey players. A total of 19 field hockey players participated in the present study for 5 days. The individuals were divided into the placebo group (PLA, n = 9) and the tart cherry juice group (TCJ, n = 10), respectively. Actigraphy devices were distributed to analyze sleep quality and participants were required to wear the device while sleeping until the study was completed. Participants consumed tart cherry juice or placebo drinks five times in a total of 48 h while double-blinded after intermittent exhaustion exercise. A significant interaction effect (group × time) between PLA and TCJ groups was not observed in the levels of melatonin and cortisol. The variables of sleep quality showed significant interaction effects with regards to the total time in bed (TTB; p = 0.015), wake after sleep onset (WASO; p = 0.044), and movement index (MI; p = 0.031) variables. As a result, our study confirmed the possibility that the short-term intake of tart cherry juice could not change the levels of melatonin and cortisol in elite female hockey players but could help improve their sleep quality.

Concussion History and Heart Rate Variability During Bouts of Acute Stress

CONTEXT

After a sport-related concussion, many athletes experience persisting neurophysiological alterations. These alterations may be absent at rest but emerge during moments of physiological stress. Unnoticed and untreated neurophysiological dysfunction may negatively affect long-term neurologic health in adolescent athletes, as they are at a critical point in development.

OBJECTIVE

To assess cardio-autonomic functioning in athletes with and those without a history of concussion by quantifying measures of heart rate variability (HRV) during times of physical and mental exertion.

DESIGN

Case-control study.

SETTING

Research laboratory.

PATIENTS OR OTHER PARTICIPANTS

Thirty-four male Hockey Quebec Midget-AAA hockey players were separated into those with (n = 16; age = 16.06 ± 0.73 years, body mass index = 23.29 ± 1.79) and those without (n = 18; age = 15.98 ± 0.62 years, body mass index = 23.60 ± 2.49) a history of concussion.

INTERVENTION(S)

All athletes underwent a series of HRV recording sessions (1) at rest, (2) while completing a cognitive task at rest, and (3) while completing a cognitive task after a bout of submaximal aerobic exercise.

MAIN OUTCOME MEASURE(S)

Time-domain measures of HRV, including mean NN intervals, SD of NN intervals, and root mean square of successive NN interval differences, were quantified for each assessment.

RESULTS

No differences in characteristics were evident between groups. No between-groups differences in HRV at rest were observed. However, during the cognitive task at rest and after aerobic exercise, athletes with a history of concussion demonstrated a higher SD of NN intervals (78.1 ± 4.3 versus 63.2 ± 4.1 milliseconds and 71.2 ± 4.3 versus 65.2 ± 3.8 milliseconds, respectively; F1,31 = 4.31, P = .046) and root mean square of successive NN interval differences (75.8 ± 6.0 versus 59.0 ± 5.6 milliseconds and 74.0 ± 5.5 versus 59.0 ± 5.2 milliseconds, respectively; F1,31 = 4.88, P = .04) than athletes without a history of concussion.

CONCLUSIONS

Concussive injuries may result in long-term cardio-autonomic dysfunction. These deficits may not be present at rest but may be triggered by physiological stress.

Dietary Intake of Young Male Ice Hockey Players 10-13 Years of Age during a Week-Long Hockey Camp

This study recorded the dietary intakes of young male ice hockey players (10-13 year (yr)) for 3 consecutive days while participating in a 5-day summer hockey camp. Players were categorized as older children (OC, n = 10; 10.7 ± 0.2 yr; 37.1 ± 1.5 kg; 147.9 ± 2.1 cm) and young adolescents (YA, n = 10; 12.9 ± 0.1 yr; 45.2 ± 1.5 kg; 157.0 ± 2.4 cm). Players consumed their usual daily intakes. Parents recorded food intake in the mornings and evenings, while the researchers recorded food intake at camp. Energy intake was higher in both groups when compared to data for age-matched young Canadian (CDN) males (OC, 2967 ± 211 vs. 2000 kcal/day; YA, 2773 ± 91 vs. 2250 kcal/day). Carbohydrate (CHO) (OC, 11.2 ± 0.8 vs. YO, 8.9 ± 0.5 g/kg body mass/day) and protein (OC, 3.2 ± 0.3; YO, 2.4 ± 0.1 g/kg/day) intakes were higher than reported for young CDN males (CHO, 3.6 and protein, 1.0 g/kg/day) and were within the Acceptable Macronutrient Distribution Range (AMDR; CHO, 56 ± 2.3; 57.4 ± 0.8%; protein, 16.1 ± 1.0; 15.7 ± 0.7%). Fat intake was also within the AMDR in both groups (OC, 29.8 ± 1.6%; YA, 28.3 ± 1.0%). Micronutrient intake was adequate except for Vitamin D intakes that were below the recommended 15 ug/day at 6.3 ± 0.7 (OC) and 5.0 ± 1.5 ug/day (YA). In summary, energy and macronutrient intakes of the OC (10-11 yr) and YA (12-13 yr) players were high and well above the age matched CDN norms. The older children had higher energy intakes/kg body mass than the young adolescents. Higher energy intakes allowed for micronutrients intakes to be met in these young active males, except for vitamin D intake.