Canadian Academy of Sport and Exercise Medicine, Canadian Sport Injury Prevention Research Symposium, Ottawa, Ontario, Canada, February 11-14, 2015

Abstract

Objective: To evaluate symptom reports (dizziness, neck pain, and headaches) and clinical measures of divided attention, cervical and vestibular function as risk factors for concussion in elite youth ice hockey players. Study Design: Cohort study. Subjects: Bantam (13-14 years) and Midget (15-17 years) male and female elite youth ice hockey players. Observation Technique: Participants completed a preseason demographic questionnaire, reported symptoms, and completed a battery of baseline clinical tests at the beginning of the season. A previously validated injury surveillance system was used. Players with a suspected concussion (identified by team therapists) were referred to the study sport medicine physician for assessment. Multivariate Poisson regression analyses were used to estimate risk of concussion using Incidence Rate Ratio (IRR), adjusted for cluster by team and exposure hours. Outcome Measures: The primary outcome of interest was concussion (defined according to international consensus guidelines) with confirmed diagnosis by sport medicine physician. Exposure variables included cervical flexor endurance test, cervical flexion rotation test, joint position error, head perturbation test, isometric anterolateral neck strength, head thrust test, dynamic visual acuity (DVA) (clinical and computerized), Functional Gait Assessment, and Walking While Talking test. Results: Individuals reporting a headache at the start of the season were 1.73 (95% CI, 1.17-2.54) times more likely to be diagnosed with a concussion during the season. Individuals reporting a headache or dizziness were more likely to be diagnosed with a concussion resulting in a time loss of .10 days [IRR = 2.27 (95% CI, 1.42-3.63) and IRR = 2.00 (95% CI, 1.06-3.78)]. Individuals who scored less than perfect on the Functional Gait Assessment were 1.98 (95% CI, 1.12-3.48) times more likely to experience a concussion with a time loss of .10 days. A poorer score on computerized DVA 85°/sec right score was protective of concussion [IRR = 0.15 (95% CI, 0.023-0.94)]. Conclusions: Symptom reports and clinical measures are intrinsic characteristics that may identify individuals at increased risk of concussion. Further evaluation to better understand the effects of a combination of these measures, to inform development of prevention strategies in high risk sport participants and utility of these measures in other populations and sports is warranted. Objective: To examine the association between previous history of concussion and Child SCAT3 scores in 11-and 12-year-old ice hockey players. Study Design: Cross-sectional. Subjects: Pee Wee ice hockey players (ages 11-12) representing all divisions of play (Calgary and Edmonton) participating during the 2013/2014 season (n = 714, male = 656, female = 58). Outcome Measures: Baseline symptoms [parent and child report (each/20 symptoms)], Standardized Assessment of Concussion [SAC (/30)], modified Balance Error Scoring System [BESS (/20)] scores, and timed tandem gait scores (in seconds) were measured using the Chi...