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Facial Protection and Head Injuries in Ice Hockey: A Systematic Review
  1. Chad Asplund (chad.asplund{at}
  1. The Ohio State University, United States
    1. Susan Bettcher (susan.bettcher{at}
    1. The Ohio State University, United States
      1. James Borchers (james.borchers{at}
      1. The Ohio State University, United States


        Objective: To summarize the best available evidence to determine if facial protection reduces head injury in ice hockey.

        Data sources: MEDLINE and Cochrane databases through January 2009.

        Review methods: Utilizing terms: “head injuries,” “craniocerebral trauma [MeSH]”, “head injuries, closed [MeSH]”, head injuries, penetrating [MeSH]”, “face mask”, “face shield”, “visor”, and “hockey”, twenty-four articles were identified through our systematic literature search. Of these, six studies met inclusion criteria. Three independent reviewers reviewed the articles. The study results and generated conclusions were extracted and agreed upon.

        Results: Studies reviewed suggest that facial protection reduces overall head injuries in ice hockey. Facial protection showed statistically significant (p<0.05) reduction in the number and type of facial injuries. In studies evaluating full facial protection versus half facial protection, full facial protection offered a significantly higher level of protection against facial injuries and lacerations than half facial protection (RR 2.31, CI 1.53-3.48). There was no significant difference in the rate of concussion (RR 0.97, CI 0.61-1.54) or neck injury (CI 0.43-3.16) between full and partial protection. However, in those that sustained concussion players with full facial protection returned to practice or games sooner than players with partial facial protection (1.7 sessions, CI 1.32-2.18).

        Conclusions: There is good evidence to support that full facial protection reduces the number and risk of overall head and facial injuries in ice hockey compared to both partial facial protection and no facial protection. Partial facial protection, while not as protective as full facial protection, appears to offer more risk reduction than no protection at all.

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