Greater Risk Of Concussion Research Articles

Physical activity and concussion risk in male youth ice hockey players

ObjectiveTo evaluate the association between self-reported physical activity (PA) and concussion incidence in male youth ice hockey players.Designpooled data from three prospective cohort studies.SettingCommunity ice hockey rinks and sport medicine clinics.ParticipantsPeeWee (ages 11–12), Bantam (ages 13–14), and Midget (ages 15–17) male youth ice hockey players (n=1208).Assesment of risk factorsParticipants reported six-week physical education and extra-curricular sport participation history upon study entry. Concussion incidence rate ratios [IRRs (95% CI)] associated with 1). total six-week PA volume, and 2). meeting the Canadian PA recommendations of one hour of daily PA (≥42 hours/six weeks) were calculated using multivariable Poisson regression (covariates: age, competition level, concussion history). Models were adjusted for hockey exposure, and cluster by team, study year and city (α<0.05).Outcome measureMedically-diagnosed concussions during the study period.Main resultsTotal PA volume did not affect concussion incidence in male youth ice hockey players [IRR: 0.996 (95% CI: 0.990–1.003]. Concussion incidence was higher in male ice hockey players who did not meet the PA recommendations versus those who met the PA recommendations amongst PeeWee [IRR: 2.94 (95% CI: 1.29–6.66)] and Bantam [IRR: 2.18 (95% CI: 1.12–3.94)] participants, but not amongst Midget participants [IRR: 1.37 (95% CI: 0.72–2.59)]. There was no evidence of confounding or modification by competition level or concussion history.ConclusionsWhile total PA volume was not associated with concussion risk, PeeWee and Bantam male youth ice hockey players whose six-week PA history was below the PA recommendations were at greater risk of concussion. This research will inform future studies examining the mechanism of this association.Competing interestsNone.

Attention problems as a risk factor for concussion in youth ice-hockey players

ObjectiveTo examine attention problems in youth ice-hockey players as a risk factor for concussion.DesignSecondary analysis of two prospective cohort studies.SettingIce-rinks and Sport Medicine Centres in two Canadian cities over three ice-hockey seasons (2011/12, 2012/13, 2014/15).Assessment of risk factorsSelf-report of formal diagnosis of attention or learning disorders were collected on previously validated preseason baseline questionnaires by all participating players. Parents and players completed the Behaviour Assessment System for Children (BASC-2), which includes inattention and hyperactivity scales.Participants2,364 Canadian ice-hockey players (11–17 years old, 87% male).Outcome measuresA previously validated prospective injury surveillance system was used. All suspected concussions were referred to the study physician for confirmation of diagnosis. Concussion risk ratios (RR) were estimated, including stratification by known risk factors.ResultsOne-hundred ninety-two of 2,215 players (9%) self-reported attention and/or learning disorders at baseline. Overall, 256 players (11%) sustained one or more concussions during a season. Players identified as “at-risk” for attention-deficit hyperactivity disorder (ADHD), based on BASC-2 T-scores (inattention and/or hyperactivity scale) greater than 60, had a greater risk of concussion during the season based on child report [RR=1.51 (95% CI 1.13–2.04)] and parent report [2.97 (95% CI 1.65–5.34)]. In players with no history of previous concussion, the RR based on child report was 1.88 (95% CI 1.22–2.90) and based on parent report was 5.03 (95% CI 2.45–10.29).ConclusionsIce-hockey players identified as “at-risk” for ADHD on the basis of baseline BASC-2 scores are at a greater risk of concussion.Competing interestsNone.

Style of Play and Rate of Concussions in the National Football League.

Background:The majority of studies on concussion in the National Football League (NFL) focus on testing, evaluation, and outcomes. Meanwhile, there is a paucity of research on how a team’s style of play influences the risk of concussion.Hypothesis:Style of play, such as offensive and defensive strategies, is associated with the rate of concussions in the NFL.Study Design:Descriptive epidemiology study.Methods:The current study retrospectively analyzed data from the 2012 to 2014 NFL regular seasons. Reported numbers of concussions were stratified by each team and each position and were compared based on style of play, including offensive scheme (West Coast offense, Air Coryell offense, or other offensive schemes) and defensive alignment (3-4 or 4-3), attempts statistics, per-drive statistics, and offensive and defensive productions, along with strength of schedule (SoS) and team quality measured by simple rating system (SRS). Data analyses included descriptive statistics, 1-way analysis of variance, correlation analysis, and regression analysis.Results:There were 437 documented concussions during the 2012 to 2014 NFL regular seasons, with a mean 4.6 concussions per season per team. In general, players most involved in pass plays reported more concussions. The number of concussions sustained by offensive players was significantly higher among the teams adopting the West Coast offense (mean, 3.0) than among those utilizing the Air Coryell offense (mean, 1.6; P = .006) or those with non–West Coast offenses combined (mean, 1.9; P = .004). The multiple regression analysis revealed that the West Coast offense or not, SoS, and SRS explained 25.3% of the variance in the number of concussions by offensive players. After accounting for SRS, the West Coast offense was found to be a significant predictor of the number of concussions (P = .007), while there was a tendency for SoS to be inversely associated with the number of concussions (P = .105). None of the variables for attempts statistics, per-drive statistics, and offensive production were significantly associated with the number of concussions in the regression analysis.Conclusion:In the NFL, players most involved in pass plays appear to be at increased risk for concussions. The West Coast offense may be associated with a greater risk of concussion. Furthermore, teams with easier schedules may have more players sustaining concussions.

Biomechanics of head impacts associated with diagnosed concussion in female collegiate ice hockey players

Epidemiological evidence suggests that female athletes may be at a greater risk of concussion than their male counterparts. The purpose of this study was to examine the biomechanics of head impacts associated with diagnosed concussions in a cohort of female collegiate ice hockey players. Instrumented helmets were worn by 58 female ice hockey players from 2 NCAA programs over a three year period. Kinematic measures of single impacts associated with diagnosed concussion and head impact exposure on days with and without diagnosed concussion were evaluated. Nine concussions were diagnosed. Head impact exposure was greater in frequency and magnitude on days of diagnosed concussions than on days without diagnosed concussion for individual athletes. Peak linear accelerations of head impacts associated with diagnosed concussion in this study are substantially lower than those previously reported in male athletes, while peak rotational accelerations are comparable. Further research is warranted to determine the extent to which female athletes’ biomechanical tolerance to concussion injuries differs from males.

DO RISK FACTORS DIFFER FOR CONCUSSION AND PROLONGED RECOVERY FOLLOWING CONCUSSION IN ELITE YOUTH ICE HOCKEY PLAYERS?

BackgroundPediatric concussion risk factor identification will facilitate targeted injury prevention strategy development.ObjectiveTo examine risk factors for concussion and prolonged recovery amongst elite youth ice hockey players.DesignCohort study.SettingCommunity ice rinks and...

What factors increase the risk of concussion in elite youth ice hockey players?

ObjectiveTo examine the risk of concussion amongst elite youth male and female ice hockey players.DesignProspective cohort study.SettingCommunity ice rinks and sport medicine clinics.Participants764 Bantam (12–14 years) and Midget (15–17 years)...

American Medical Society for Sports Medicine Position Statement

Abstract:Sport-related concussion (SRC) is a common injury in recreational and organized sport. Over the past 30 years, there has been significant progress in our scientific understanding of SRC, which in turn has driven the development of clinical guidelines for diagnosis, assessment, and managemen

Gender Differences in Head???Neck Segment Dynamic Stabilization during Head Acceleration

Recent epidemiological research has revealed that gender differences exist in concussion incidence but no study has investigated why females may be at greater risk of concussion. Our purpose was to determine whether gender differences existed in head-neck segment kinematic and neuromuscular control variables responses to an external force application with and without neck muscle preactivation. Forty (20 females and 20 males) physically active volunteers participated in the study. The independent variables were gender, force application (known vs unknown), and force direction (forced flexion vs forced extension). The dependent variables were kinematic and EMG variables, head-neck segment stiffness, and head-neck segment flexor and extensor isometric strength. Statistical analyses consisted of multiple multivariate and univariate analyses of variance, follow-up univariate analyses of variance, and t-tests (P < or = 0.05). Gender differences existed in head-neck segment dynamic stabilization during head angular acceleration. Females exhibited significantly greater head-neck segment peak angular acceleration (50%) and displacement (39%) than males despite initiating muscle activity significantly earlier (SCM only) and using a greater percentage of their maximum head-neck segment muscle activity (79% peak activity and 117% muscle activity area). The head-neck segment angular acceleration differences may be because females exhibited significantly less isometric strength (49%), neck girth (30%), and head mass (43%), resulting in lower levels of head-neck segment stiffness (29%). For our subject demographic, the results revealed gender differences in head-neck segment dynamic stabilization during head acceleration in response to an external force application. Females exhibited significantly greater head-neck segment peak angular acceleration and displacement than males despite initiating muscle activity earlier (SCM only) and using a greater percentage of their maximum head-neck segment muscle activity.