1. The rate of concussions sustained in youth ice hockey was 1.58 injuries for every 1000 combined games and practices, which was similar to other youth contact sports.
2. A higher rate of concussions was seen during games than in practices, and among 12- 14 year olds when compared to older youth.
Evidence Rating Level: 2 (Good)
Study Rundown: With increasing participation in youth ice hockey, the rate of sustained concussions has increased dramatically in recent years. Several studies have touched on this public health issue, but there has been limited investigation of concussion rates in youth ice hockey. Authors of the current study sought to compare concussion rates in practice and competition among male and female ice hockey players who were 12 to 18 years old. Researchers concluded that the rate of concussions was comparable to other youth contact sports. Nearly 10% of participants sustained a concussion with over a third involving illegal contact. The rate of concussions was higher during games in both age groups, but the 12 to 14 year olds had a higher rate of injury than the 15- to 18-year-old group, which may be secondary to the greater variation in youth size and development in this age group. This study may be limited due to small sample size, lack of generalizability, lack of data on individual participant playing time, and the self-reporting of injuries. However, providers may use these results to counsel parents about the potential dangers of ice hockey participation, especially among young teens.
Study Author, Dr. Anthony P. Kontos, PhD, talks to 2 Minute Medicine: Research Director, University of Pittsburg Medical Center Sports Medicine Concussion Program, and Associate Professor, Department of Orthopaedic Surgery, University of Pittsburg.
“The current study provides empirical data that suggests that concussion risk in youth ice hockey is comparable to other youth sports. The findings highlight the importance of providing medical coverage not only during ice hockey games but also during practices- where more concussions occurred than expected. The findings also suggest that adolescent players aged 12-14 may be at higher risk from concussion than older players aged 15-18- possibly due to unfamiliarity with checking, disparities in body size/strength, which highlights the need for concussion awareness and clinical care in this at-risk age group.”
In-Depth [prospective cohort]: Concussions among a total of 401 youth ice hockey players (ages 12 to 18 years old) from Pennsylvania, Massachusetts, and Alabama were studied between September 2012 to April 2013 and from September 2013 to April 2014. Concussions were identified as closed head injuries which altered cognitive functioning, led to obvious symptoms (headache, dizziness, nausea, etc.), or caused a loss of consciousness < 1 minute. A coach or parent representative from each team was trained to report suspected concussion injuries. A total of 37 (9.3%) players sustained concussions during the study period (11 during practice/26 during games). All injuries involved player-to-player contact and 43% were related to illegal contact resulting in a penalty. The combined incidence rate for games and practices was 1.58 concussions per 1000 exposures (95%CI 1.13- 2.16), and the ratio between concussions in games to practices was 2.86 (95%CI 1.43- 6.01, p = .01). The combined practice and game ratio of concussions between 12- to 14-year olds and 15- to 18-year olds was 2.40 (95%CI 1.23- 4.61, p = .01).
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