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A prospective study of physician-observed concussion during a varsity university ice hockey season: incidence and neuropsychological changes. Part 2 of 4.
Neurosurg Focus 2012; 33(6):E2: 1-11NF

Abstract

OBJECT

The primary objective of this study was to measure the incidence of concussion according to a relative number of athlete exposures among 25 male and 20 female varsity ice hockey players. The secondary objective was to present neuropsychological test results between preseason and postseason play and at 72 hours, 2 weeks, and 2 months after concussion.

METHODS

Every player underwent baseline assessments using the Sport Concussion Assessment Tool-2 (SCAT2), Immediate Post-Concussion Assessment and Cognitive Test (ImPACT), and MRI. Each regular season and postseason game was observed by 2 independent observers (a physician and a nonphysician observer). Players with a diagnosed concussion were removed from the game, examined in the team physician's office using the SCAT2 and ImPACT, and sent to undergo MRI.

RESULTS

Eleven concussions occurred during the 55 physician-observed games (20%). The incidence of concussion, expressed as number of concussions per 1000 athlete exposures, was 10.70 for men and women combined in regular season play, 11.76 for men and women combined across both the regular season and playoff season, 7.50 for men and 14.93 for women in regular season play, and 8.47 for men across both the regular season and playoff season. One male player experienced repeat concussions. No concussions were reported during practice sessions, and 1 concussion was observed and diagnosed in an exhibition game. Neuropsychological testing suggested no statistically significant preseason/postseason differences between athletes who sustained a physician-diagnosed concussion and athletes who did not sustain a physician-diagnosed concussion on either the ImPACT or SCAT2. The athletes who sustained a physician-diagnosed concussion demonstrated few reliable changes postinjury.

CONCLUSIONS

Although the incidence of game-related concussions per 1000 athlete exposures in this study was half the highest rate reported in the authors' previous research, it was 3 times higher than the incidence reported by other authors within the literature concerning men's collegiate ice hockey and 5 times higher than the highest rate previously reported for woman's collegiate ice hockey. Interestingly, the present results suggest a substantively higher incidence of concussion among women (14.93) than men (7.50). The reproducible and significantly higher incidence of concussion among both men and woman ice hockey players, when compared with nonphysician-observed games, suggests a significant underestimation of sports concussion in the scientific literature.

Authors+Show Affiliations

Elliott Sports Medicine Clinic, Burlington, Ontario, Canada. psechlin@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23199425

Citation

Echlin, Paul S., et al. "A Prospective Study of Physician-observed Concussion During a Varsity University Ice Hockey Season: Incidence and Neuropsychological Changes. Part 2 of 4." Neurosurgical Focus, vol. 33, no. 6, 2012, pp. E2: 1-11.
Echlin PS, Skopelja EN, Worsley R, et al. A prospective study of physician-observed concussion during a varsity university ice hockey season: incidence and neuropsychological changes. Part 2 of 4. Neurosurg Focus. 2012;33(6):E2: 1-11.
Echlin, P. S., Skopelja, E. N., Worsley, R., Dadachanji, S. B., Lloyd-Smith, D. R., Taunton, J. A., ... Johnson, A. M. (2012). A prospective study of physician-observed concussion during a varsity university ice hockey season: incidence and neuropsychological changes. Part 2 of 4. Neurosurgical Focus, 33(6), pp. E2: 1-11. doi:10.3171/2012.10.FOCUS12286.
Echlin PS, et al. A Prospective Study of Physician-observed Concussion During a Varsity University Ice Hockey Season: Incidence and Neuropsychological Changes. Part 2 of 4. Neurosurg Focus. 2012;33(6):E2: 1-11. PubMed PMID: 23199425.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A prospective study of physician-observed concussion during a varsity university ice hockey season: incidence and neuropsychological changes. Part 2 of 4. AU - Echlin,Paul S, AU - Skopelja,Elaine N, AU - Worsley,Rachel, AU - Dadachanji,Shiroy B, AU - Lloyd-Smith,D Rob, AU - Taunton,Jack A, AU - Forwell,Lorie A, AU - Johnson,Andrew M, PY - 2012/12/4/entrez PY - 2012/12/4/pubmed PY - 2013/5/23/medline SP - E2: 1-11 JF - Neurosurgical focus JO - Neurosurg Focus VL - 33 IS - 6 N2 - OBJECT: The primary objective of this study was to measure the incidence of concussion according to a relative number of athlete exposures among 25 male and 20 female varsity ice hockey players. The secondary objective was to present neuropsychological test results between preseason and postseason play and at 72 hours, 2 weeks, and 2 months after concussion. METHODS: Every player underwent baseline assessments using the Sport Concussion Assessment Tool-2 (SCAT2), Immediate Post-Concussion Assessment and Cognitive Test (ImPACT), and MRI. Each regular season and postseason game was observed by 2 independent observers (a physician and a nonphysician observer). Players with a diagnosed concussion were removed from the game, examined in the team physician's office using the SCAT2 and ImPACT, and sent to undergo MRI. RESULTS: Eleven concussions occurred during the 55 physician-observed games (20%). The incidence of concussion, expressed as number of concussions per 1000 athlete exposures, was 10.70 for men and women combined in regular season play, 11.76 for men and women combined across both the regular season and playoff season, 7.50 for men and 14.93 for women in regular season play, and 8.47 for men across both the regular season and playoff season. One male player experienced repeat concussions. No concussions were reported during practice sessions, and 1 concussion was observed and diagnosed in an exhibition game. Neuropsychological testing suggested no statistically significant preseason/postseason differences between athletes who sustained a physician-diagnosed concussion and athletes who did not sustain a physician-diagnosed concussion on either the ImPACT or SCAT2. The athletes who sustained a physician-diagnosed concussion demonstrated few reliable changes postinjury. CONCLUSIONS: Although the incidence of game-related concussions per 1000 athlete exposures in this study was half the highest rate reported in the authors' previous research, it was 3 times higher than the incidence reported by other authors within the literature concerning men's collegiate ice hockey and 5 times higher than the highest rate previously reported for woman's collegiate ice hockey. Interestingly, the present results suggest a substantively higher incidence of concussion among women (14.93) than men (7.50). The reproducible and significantly higher incidence of concussion among both men and woman ice hockey players, when compared with nonphysician-observed games, suggests a significant underestimation of sports concussion in the scientific literature. SN - 1092-0684 UR - https://www.unboundmedicine.com/medline/citation/23199425/A_prospective_study_of_physician_observed_concussion_during_a_varsity_university_ice_hockey_season:_incidence_and_neuropsychological_changes__Part_2_of_4_ L2 - https://thejns.org/doi/10.3171/2012.10.FOCUS12286 DB - PRIME DP - Unbound Medicine ER -